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THE 

HOMOEOPATHIC TREATMENT 

SYPHILIS, G0N0RRH(EA, 

SPERMATORRHEA, 

AND 

URINARY DISEASES. 






COMPILED BT 

J. PH. BEKJEAU, 

AUTHOR OF 'PHYSIOLOGICAL SYNOPSIS OF HOMCEOPATH Y.' 

^rngtH, with gtuttwrmttf ^fldiftms, 
By J. H. P. FROST, M. D., 

LATE PROFESSOR OP PHYSIOLOGY AND PATHOLOGY IN THE 
HOM. MED. COLLEGE OF PENNSYLVANIA. 

^ PHILADELPHIA : 
PUBLISHED BY A. J. TAFEL. 
1870. 




Entered according to Act of Congress, in the year 1869, by 

A. J. TAFEL, 

In the Clerk's Office of the District Conrt of the United States in and for 
the Eastern District of Pennsylvania. 

STEREOTYPED BY J. FAGAN & SON. 




CAXTON PRESS OF 
SHERMAN & CO., PHILADELPHIA. 



PREFACE TO THE FIRST ENGLISH EDITION. 



The acknowledged want of a Homoeopathic treatise 
on Urinary and Syphilitic Diseases has induced me to 
compile the present volume from the few authorities 
(homoeopathic) who have given the results of their ex- 
perience to the world. I have endeavored to render 
the descriptions and treatment of the diseases as con- 
cise and as intelligible as possible, without being ob- 
scure, and have consequently rejected (as much as 
possible) the use of technical phraseology, which is. 
in treatises of this kind, almost unavoidable. 

The principal authors to whom I am indebted for 
much of the practical information, are Drs. Laurie, of 
London; Gollmann, of Vienna; and Humphrey, of 
Philadelphia, U. S,; to whom I tender my best ac- 
knowledgments. 

J. Ph. Berjeau. 

London, December, 1856. 

vii 



PREFACE 

TO THE FIRST AMERICAN EDITION. 



Having been requested to revise Dr. Berjeau's 
excellent treatise, for republication in this country, it 
is proper to mention the alterations and additions 
which have been made to the Second English Edition. 

[The principal additions made by the American 
Editor will be found enclosed in brackets, like this 
sentence.] 

The repeated dose-directions have been omitted as 
unnecessary, and the whole work condensed in va- 
rious ways (without omitting anything else), in order 
to introduce new matter, and, at the same time, avoid 
increasing too much the size of the book, or enhancing 
its price. 

The full discussion of the dose, added by the Editor, 
will, it is believed, be found to contain directions 
amply sufficient for the junior practitioner. Those 
more experienced will need no such guidance. 

The treatment of acute and chronic Gonorrhoea, as 
well in the female as in the male, and of Gleet, has been 
much more fully set forth. Here will now be found, 



X PREFACE TO THE 

in addition to the system advised by our author, the 
various methods recommended by particular physicians 
of eminence; and also that which corresponds with 
our own experience, and which is believed to be most 
strictly in accordance with Homoeopathic principles. 
We refer here more especially to what we have said 
of intercurrent anti-psoric treatment in venereal cases. 

The entire chapter on Venereal Rheumatism has 
been added to the work in this edition. Important 
additions will be found under Condylomata; Hema- 
turia; Orchitis; Prostatitis; Chancre, and numerous 
other headings. 

Similar additions also appear, in connection with 
Syphilis, and Syphilitic disorders. And in every part 
of the work numerous minute additions occur, — which 
it would not have been deemed worth while to enclose 
in brackets, but from an unwillingness to make the 
Author responsible for what he had not_ written. 

The chapter on Cerebrospinal Meningitis, ori- 
ginally published in the fourth volume of the Hahne- 
mannian Monthly, has been inserted as necessary to 
cover the vacant ground between the Spinal Irritation, 
and Tabes Dorsalis of Berjeau. 

Some important New Remedies have also been in- 
troduced ; such as Copaiba and Occimum canum, in 
Hematuria and Renal Colic; Tussilago petasites, in 
Gonorrhoea ; Nat mur. and Mezereum, in Gleet ; Eu- 
phrasia, Nitric acid, and Sabina, in Condylomata; 
and Jacaranda caroba and Phytolacca decandra, in 
Syphilis. 



FIRST AMERICAN EDITION. XI 

From the larger work of Jahr (translated, with ad- 
ditions, by Dr. Hempel) many important items have 
been gleaned. From Professor Heme's Pathology 
and Therapeutics w r e have taken some valuable indi- 
cations. Some interesting matter has also been de- 
rived from American Horn. Periodical Literature — 
neither of these three sources having been accessible 
to Berjeau in preparing the work; and while we have 
thus sought in all directions for w T hatever would 
tend to enhance the practical utility of the present 
edition, or to confirm the treatment recommended, 
due credit has been given in every instance. And in 
regard to what we have ourselves advised, it is proper 
to state, that the conclusions we have reached on the 
subjects contained in the present work, and the cor- 
responding suggestions which it offers, are the results 
of twenty years' experience in our own practice, and 
of a still larger observation of that of others. 

J. H. P. Feost, M.D. 

Bethlehem, Pa., July, 1869. 



INTRODUCTION. 



SYPHILITIC diseases arise either directly or in- 
directly from an impure coition, and may be trans- 
mitted to other persons in a similar manner to the inocu- 
lation of the small-pox. After breaking out at first on 
the sexual organs, the disease is carried through the 
whole organism by means of the lymphatic system ; 
this, at least, is Bjcord's opinion, who holds that the 
disease (syphilis) is at first only local, although by Ho- 
moeopaths it is held (and I believe justly) that the in- 
fection at once pervades the whole system, and being 
gradually matured, shows itself at first on the genera- 
tive organs, and afterwards in the throat, (secondary 
syphilis,) the character of the ulcers being the same, and 
therefore is not to be treated by caustics aud other 
repellent remedies. The true venereal disease develops 
itself at the spot where the infectious matter is first 
communicated to the organism ; at this stage the disease 
yields readily to appropriate treatment. But if the 
parts round the ulcer become hard, the disease becomes 
more obstinate, and a course of medicine is requisite for 
its removal. Secondary syphilis, or that stage when 
other symptoms begin to show the action of the virus 
on the system, is still contagious, though in a remoter 
2 13 



14 INTRODUCTION. 

degree, whilst the latter stages are non-contagious ; 
hence the denominations of primary and constitutional 
syphilis, and the subdivision of the latter into secondary 
and tertiary syphilis. 

Primary Syphilis. — In the majority of cases, pri- 
mary symptoms affect the mucous membrane of the gen- 
ital organs, the anus, the mouth, and nipples. It may 
likewise occur, but accidentally, in the eye, nose, or in 
excoriated wounds, in consequence of the pus getting at 
these parts. Infection may likewise take place in dress- 
ing syphilitic ulcers, and may be communicated to the 
infant by the nursing mother, as by the infant to the 
wet-nurse. The infectious matter may also be trans- 
mitted by means of glasses, spoons, tobacco-pipes, sur- 
gical instruments, &c, which have been used by diseased 
persons, and not properly washed from the matter which 
may accidentally have adhered to them. 

Constitutional Syphilis. — This form develops itself 
sooner or later after the appearance of the chancre ; the 
first signs are cutaneous eruptions, accompanied with 
ulceration of the tonsils, and even by pains in the bones; 
the laryngeal and nasal membranes are later invaded. 
It is only, however, manifested in certain organs, or 
parts of organs, as the mucous membranes of the mouth, 
fauces, nose, rectum, and sexual organs, the skin and its 
appendages, the lymphatic system, the muscles and ten- 
dons, the brain and its membranes, the periosteum and 
bones, the iris, testicles and ovaries, and the liver. The 
eruptions are generally copper-colored and rounded. 
The disease seldom affects more than one organ at once, 



INTRODUCTION. 15 

but gradually develops itself, according to Ricord, in 
two successive periods, termed secondary and tertiary 
syphilis — the two forms sometimes co-existing at the 
same period. 

Secondary syphilis manifests itself by a feverish re- 
action, termed syphilitic eruptive fever ;' the mucous 
membranes are first invaded by the specific inflamma- 
tion, succeeded by morbid growths and indurations, and 
alterations of structure ; the mouth, fauces, and adjoin- 
ing parts are attacked before the mucous membrane 
of the genital organs ; afterwards cutaneous eruptions, 
termed " syphilides," supervene, and finally syphilitic 
iritis. The first sign of secondary syphilis is a feeling 
of malaise throughout the body : afterwards the patient 
experiences violent headache, heaviness, and tearing in 
the shoulders, forearms, small of the back, legs, and knees, 
excessive languor, restlessness, sleeplessness, thirst, con- 
stipation, and hot, slightly moist skin. The glands of 
the neck begin to swell, the cicatrices of the primary 
ulcers become darker, sensitive, swell, and grow larger 
and harder. 

Tertiary syphilis differs from secondary syphilis in 
this, that it is no longer transmissible to the foetus and 
is no more contagious ; the older the disease is, and the 
longer it lasts, the more it becomes divested of its spe- 
cific character, and takes the form of a dyscrasia, sim- 
ulating the scrofulous diathesis. It is always preceded 
by the two former stages, and shows itself not sooner 
than six months after the disappearance of the chancre ; 
sometimes it breaks out ten or twenty years after the 



16 INTRODUCTION. 

first infection ; tertiary symptoms affect particularly the 
subcutaneous and submucous cellular tissue, the fibrous, 
osseous, and cartilaginous tissues, and, lastly, the nerves, 
parenchymatous (fleshy) organs, and, in short, the whole 
organism. 

Hygiene. — Highly-seasoned food, tea, coffee, spices, 
wine, malt and spirituous liquors, not only antidoting 
the effects of the attenuated remedies, but by their al- 
most immediate injurious action on the urinary organs, 
should be avoided with the utmost care. Fat, heavy, 
indigestible food is likewise to be rejected. Besides rest 
of mind, which is essential, complete rest of body will be 
found most advantageous in most cases, and the patient 
should be kept in a rather elevated temperature. His 
habitual beverage should be water, toast-, barley-, or rice- 
water, and cocoa. He should be careful also not to ex- 
pose the sexual parts to cold or damp, to avoid all violent 
exertion, and even all bodily exercise in the inflamma- 
tory stage of the disease. 

Selection of the Medicines. — It will always be ad- 
visable, particularly when the disease is complicated, to 
write down on paper the symptoms as enumerated by 
the patient himself, or revealed to the practitioner by 
the pathological signs of the morbid alteration. When 
every particular is ascertained, and not till then, should 
reference be made to the therapeutical indications for 
the remedy, and especially to the alphabetic repertory 
given at the end of most of the varieties. With a little 
trouble, the remedy which occurs the most frequently in 
the collation of the symptoms will be found the suitable 



INTRODUCTION. 17 

one, and is to be given according to the urgency of the 
case, in the manner described below, unless otherwise 
specially directed. It will be especially advisable to 
note the state of the patient's disposition at that time, 
as that exercises a most important influence in the selec- 
tion. For instance, should a case of chancre, for which Mer- 
curius appears the most suitable, be accompanied with 
great depression and tendency to suicide, Aurtjm would 
be the appropriate medicine ; other intermediate ones 
are also occasionally required, as Veratrum for reli- 
gious melancholy, Pulsatilla for a weeping mood, Cof- 
fea for a nervous state, Bryonia, or Nux for irritable 
persons ; these, however, are not curative to the syphilitic 
affection, but only remove certain abnormal symptoms 
which are apt to retard the cure. Those medicines 
which are curative in syphilis will be found to be espe- 
cially noticed in the indications for that disease. 

Doses. — A new dose is never to be given so long as 
a good action continues, and particularly when low at- 
tenuations are given, it being necessary to watch the 
effect of the medicine, and to change it, if improvement 
does not speedily follow the first few doses. 

[Berjeau, the author of this book, gave after each 
medicine, in every form of disease treated herein, pre- 
cise directions as to the size and repetition of the dose. 
These repeated dose-directions it has been thought best 
to omit ; since it is evident that practitioners will be- 
come far more successful in treating their patients if 
they accustom themselves to the exercise of a sound 
2* 



18 INTKODUCTIOJST. 

judgment in the application of the best principles to 
each individual case. 

Still, it is but just to the author to indicate, once for 
all, his particular method. He advised, altogether, the 
lower preparations ; usually five drops of the mother 
tincture of plants, or five grains of the second decimal 
(or centesimal) trituration of minerals ; or five drops of 
the first, second, third, fourth, fifth, or sixth dilution, to be 
given for a single dose. This dose he usually advised 
to be dissolved in a wine-glass of water, and repeated 
once an hour ; once in three or four hours ; or three or 
four times a day, according to circumstances. In other 
respects he avoids all empiricism ; and seeks to cure his 
patients by administering the remedy homoeopathically 
suited to the actual condition. 

Every experienced physician will of course continue 
the system of medication, as to potency and repetition 
of dose, which he has found most advantageous. But, 
having thus indicated the method pursued by our au- 
thor, as well in justice to himself as for the considera- 
tion of less experienced practitioners, we subjoin also 
our own views, and those adopted by others, whose 
abilities and successful experience entitle them to re- 
spect. 

Pure homoeopathy points out the best way (it may be 
a " narrow way," — for there is no " broad " or " royal 
road" in the art of medicine, any more than in the sci- 
ence of knowledge) to heal the sick. The method of 
finding specifics for special diseases (the " philosopher's 
stone " of doctors) is just plausible enough to be falla- 
cious, and just apparently successful enough to prove a 
delusion and a snare. The venereal disease, gonorrhoea 



INTKODUCTIOIST. 19 

especially, has long been regarded as the opprobrium 
medicorum ; very much like " fever and ague." But the 
result of allopathic modes of medication — i. e., massive 
doses empirically prescribed — has thus far been, if pos- 
sible, less satisfactory in the former kind of disorder than 
in the latter. 

Chronic cases of venereal disease, like chronic cases 
of intermittent, we think may be best cured by rare doses 
of the* higher Homoeopathic preparations* If there is 
any exception to this, it arises from the apparent neces- 
sity of antidoting, with lower forms of the appropriate 
medicines, the mercurial poisons which may be still 
actually present in the system even in massive quanti- 
ties ; while chronic cases of mercurial and mercurio- 
syphilitic disease have been found to yield to the higher 
and highest potencies of Mercurius itself. But even in 
these chronic cases, especially of syphilitic disease, very 
many, perhaps the great majority, of our physicians 
have more confidence in the lower Homoeopathic prepa- 
rations. 

Recent cases of venereal disease, both gonorrhoea! and 
syphilitic, may also be cured — have been very promptly 
cured — by the higher and highest potencies. But to 
make such cures requires a more profound mastery of 
the Materia Meclica, a greater amount of experience, 
and a more absolute control of the patient's confidence 
than many, especially the junior, members of the pro- 
fession can command. Few, indeed, ever attempt it. 

The comparative failure to cure venereal disease, like 

* Numerous cases of such cures may be found recorded in the 
periodical literature of our school. See Am. Horn. Review, Vol. 
III. p. 211. 



20 INTRODUCTION. 

that of intermittent, has not therefore resulted from 
using too little medicine. The real cause of ill-success, 
in the one case as in the other, is to be found in prescrib- 
ing for the disease rather than for the patient. Let the 
remedy be carefully adapted to the particular symptoms 
and constitution of the individual patient, and we believe 
he can be as readily and as speedily cured in venereal 
as in other forms of disease; and that too without his 
system being salivated by mercury, or sickened by 
copaiba. 

The ordinary low Homoeopathic preparations, such as 
the third dilution of the plants, and the sixth of min- 
erals, may answer very well in recent cases of gonor- 
rhoea. Of these the dose need not be larger, or oftener 
repeated than is customary for inflammatory affections 
of a corresponding grade. Some physicians may prefer 
to administer the larger, five-drop, doses advised by 
Berjeau. 

In recent cases of Syphilis, we think the great majority 
of experienced physicians prefer to depend on the first or 
second centesimal (or even decimal) triturations, in doses 
of one or two grains, repeated two, three, or four times 
a day. Some more precise indications, in this respect, 
will appear in the subsequent pages, — such as may be 
gleaned from the particular prescriptions of individual 
physicians. 

As to the repetition of the dose, and to the change of 
medicine, " a new dose is never to be given as long as a 
good action continues." But, the medicine being care- 
fully chosen, suited to the existing state as exactly as 
possible, be sure and not change it for another, except 
under one of the three following conditions : 



INTRODUCTION. 21 

I. When no further improvement can be seen to ac- 
company or to follow its use. 

II. When some new forms of the disease appear, — 
some of the old symptoms being removed, or others aris- 
ing into greater prominence, — which render the whole 
case different, and the original remedy no longer Ho- 
moeopathic to it. 

III. When satisfied that the remedy itself was not, 
even in the first instance, Homoeopathic to the case. 

In either of these contingencies a new prescription 
should be made to suit the existing condition. 

Finally, a single word may be given on the vexed ques- 
tion of alternation. As a matter of fact, it must be ac- 
knowledged that the greater number of Homoeopathic 
physicians do alternate. As a matter of principle, it is, we 
think, pretty generally acknowledged, even by those who 
practise it, that alternation is not to be defended. To 
this there may be some exceptions ; of these exceptions, 
and of the reasons for them, an ably written statement 
may be found in the June number of the Hahnemannian 
Monthly, 1867.* But we are thoroughly satisfied, that, 
in most of venereal as of other kinds of disease, the 
physician will much more rapidly and thoroughly cure 
his patients, if he will give them but one remedy at a 
time ; and it is obvious that he will in this way acquire 
a much more complete knowledge of what can be done 
with each single drug. He who practises in this way 
will soon learn how to give his doses so as not to aggra- 
vate his patient's symptoms, that is, not to make them 
too large or to repeat them too often. The law of the 

* Report on Alternation. By Dr. Win. E. Payne. Hah. Monthly, 
Vol. II. p. 781. 



22 INTRODUCTION. 

single remedy proves an excellent " schoolmaster " to 
those who will faithfully follow it. What is here said, 
however, is not intended to apply to the careful adminis- 
tration of an intercurrent (anti-psoric) rerned} r , as after- 
wards recommended ; a method which, so far from con- 
tradicting Homoeopathic principles, seems to be in strict 
accordance with them.] 



SYPHILIS, GONORRHOEA, 



THEIR CONCOMITANTS. 



GONORRHEA. 



THIS is a violent inflammation of the mucous mem- 
brane of the urethra, with purulent discharge. It 
manifests itself from two to seven days after an impure 
connection, when the patient experiences at the end of 
the penis a peculiar itching, which increases to a real pain 
during erection : the pain is also greatly aggravated by 
urinating, and sometimes becomes intolerable as the dis- 
ease progresses. Two or three days after the first symp- 
toms the orifice of the urethra becomes red, swollen, 
and moist ; tensive and drawing pain invades the sper- 
matic cord, the testes, and inguinal region ; the patient 
experiences a burning pain after micturition, which in- 
creases daily, as well as the swelling and redness of the 
urethra ; and the discharge, at first inconsiderable, clear, 
and viscid, causes the sides of the orifice to adhere, and 
stains the linen. The glans becomes hot, red, swollen, 
and painful, whilst frequent erections at night produce 
distressing pain and disturb the sleep. After a week 

23 



24: GONORRHOEA. 

the discharge is much increased, becomes thicker, of a 
yellowish-white color, w T hilst the pain during urination 
and during erection is extremely violent, and extends 
the whole length of the penis. With the inflammation 
the urethra becomes contracted, and the stream of urine 
is divided. This second stage continues for another 
Aveek or fortnight. 

When the inflammatory symptoms begin to decline, 
the emission of urine and the erections become less pain- 
ful, and occasionally altogether painless, yet nevertheless 
the discharge continues, but changes to a whitish, viscid, 
stringy secretion. 

If these last symptoms remain unaltered for a while, 
the disease is called gleet, or secondary gonorrhoea. 

Numerous causes besides impure coition give rise to a 
gonorrheal discharge, running the same course as vene- 
real gonorrhoea. Such are the use of new wine, unfer- 
mented beer, the exposure of the parts to a cold wind 
whilst urinating, mechanical and chemical lesions, na- 
tural predisposition, constitutional debility, scrofulous 
diathesis, gout and cutaneous eruptions, and last, not 
least, from the presence of leucorrhoea (the whites) in 
the female; gonorrhoea taking its origin in non-syphilitic 
causes being frequently more intractable than the true 
one. 

Treatment. — " This disease sometimes proves very 
intractable, even in homoeopathic practice ; but if the 
treatment is commenced sufficiently early, it terminates 
much less frequently in the secondary form of the mala- 
dy, and the other serious consequences detailed, than it 
does in allopathic practice."* 

* Laurie, "Elements of Homoeopathic Practice of Physic," 2d 
edit., p. 468 



GONORRHOEA. 25 

The first and important rule is to avoid entirely the 
use of injections, which have a tendency to suppress the 
discharge, and to give rise to swelled testicle and 
other serious complaints. A strict abstemious diet must 
be enforced, and the patient should remain at home, and 
recline in a horizontal position. 

When, however, that is impossible, the use of a sus- 
pensory bandage becomes absolutely necessary. Strict 
attention to cleanliness should not be neglected, the 
employment of warm water often giving striking relief, 
besides being useful in loosening the linen, which fre- 
quently adheres to the part, and which always should 
be removed before urinating. 

Prophylactic Treatment. — Well washing the parts 
with a solution of soap, (or covering them before con- 
nection with oil,) and voiding urine immediately after a 
suspicious intercourse has taken place, will prevent the 
syphilitic virus from adhering to the mucous membrane, 
and giving rise to an infection. Should, however, these 
precautions not be taken, the use of medicines will gen- 
erally prevent, or greatly lessen any mischief that might 
ensue. 

Should, however, the presence of leucorrhcea in the 
female be suspected, Tincture of Sulphur is to be sub- 
stituted for the mercurial preparation. It is also to be 
noticed that an abstinence from beer or spirits for a few 
days, and the plentiful use of demulcent drinks, as lin- 
seed tea, gum-water and barley-water, with cold water 
ad libitum, (if the others are not easily procurable,) to 
dilute the urine, may prevent a great deal of unneces- 
sary suffering. Should, however, the fever and inflam- 
mation set in severely, animal food must be totally ab- 
3 



26 GONORRHCEA. 

stained from, and the patient subsist on demulcent 
drinks and slops. 

[We add here the treatment recommended by different 
physicians. Jahr* advises Sepia, 30 dry, morning and 
evening, when the patient complains only of titillation 
at the orifice of the urethra, with slight redness and a 
scarcely perceptible secretion, barely sufficient to close 
the orifice by agglutination. In this way he frequently 
effects a speedy cure, without any inflammation super- 
vening. In the same circumstances, Grauvogl as strongly 
recommends Natrum sulph. in the first or incipient stage. 
But, to return to Jahr's method, if the patient has the 
secretion already quite copious ; or if the inflammatory 
period is already more or less advanced ; or if Sepia has 
failed to diminish the incipient symptoms and cut short 
the disease, Jahr advises Cannabis* dry, night and morn- 
ing, " without paying any attention to consensual symp- 
toms ;" and says that "perseverance in this remedy two, 
or at most three, weeks will suffice to radically cure every 
case of gonorrhoea, provided the patient keep a very strict 
diet and his case is not complicated with any syphilitic 
taint." 

If the patient presents himself after the inflammation 
has subsided, with a continual painless more or less pro- 
fuse discharge, he gives the Cannabis where it has not 
been used previously ; if the case, nearly cured by Can- 
nobis, becomes aggravated by errors of diet, he restores 
the normal condition of things by means of a few doses 
of Cannabis, If Cannabis, in either of these two cases, 

* Jahr's Venereal Diseases, Translated by Dr. C. J. HempeJ, 
New York, 1868. 



GONORRHOEA. 27 

prove of no avail, he gives half-grain doses of the second 
trituration of Mercurius vivus once in three or four days. 

As showing the contrast of modes of treating this dis- 
ease, we subjoin Dr. Wni. H. Holcombe's " Usual Treat- 
ment of Acute Gonorrhoea." * " Put one or two drops 
of Copaiba into an ounce of alcohol, succuss thoroughly, 
and give ten drops three times a day. Inject every six 
hours a small glass syringe of the following solution: 
Acetate of lead, four grains ; Acetate of morphine, four 
grains ; water, four ounces. Enjoin rest and low diet 
for one week." 

In cases where a few, scarcely perceptible drops are 
still secreted, (gleet,) which are quite unmanageable and 
resist all treatment, Jahr advises Sepia, Sulphur, or 
Pulsatilla ; or if the secretion is of a milky whiteness, 
Capsicum and Ferrum. In- some cases, he says, Tus- 
silago and Natrum mur. have rendered excellent service. 

It is well known that, while many cases of gonorrhoea 
are readily cured, (some patients even curing themselves 
by mild remedies and gently astringent injections,) nu- 
merous others have proved so intractable as to wear out 
the patience of the sufferer, and exhaust in vain the skill 
of able and eminent physicians. In the greater number 
of such cases, the failure must be attributed to the pres- 
ence of psomc (or it may be even an unsuspected syphi- 
litic or sycotic) miasm in the system. Which miasm the 
physician fails to antidote by his direct method of treat- 
ing the gonorrhoea or gleet; that is, of prescribing for the 
disease instead of for the patient himself! By this latter 
and only true, Homoeopathic, and really curative method, 

* U. S. Med. and Surg. Journal, Vol. I. p. 231. April, 1866. 



28 GONORRHOEA. 

the physician will discover the evidences or symptoms 
which represent the latent miasm, and thus adapting his 
prescription to the actual conditions, or interior patho- 
logical state which they indicate, will often effect cures 
which to the uninitiated seem like magic. It is thus 
that we have seen a single dose of Sulphur zo remove in 
a few days, and forever, a gleety discharge which had 
resisted all other treatment for months. 

But, to return to the treatment of recent and fully 
established cases of gonorrhoea, with Berjeau's advice 
to use Aconite at first, to remove the severe inflamma- 
tion, we entirely coincide. Then Cannabis, Cantharis, 
Argenti nitras, or whatever other remedy corresponds 
most nearly to all the symptoms of the patient, should 
be given. The selected remedy is variously given in 
five-drop doses of the mother tincture, (especially Can- 
nobis, by Berjeau almost despised, of which Dr. Hempel * 
advises from five to thirty drops a day; Dr. Yeldam,f 
" five to ten, or even fifteen drops of the mother tincture, 
three or four times a day;" and of which Ruekert J says, 
"large doses are preferable in gonorrhoea,") or in five- 
drop doses of any one of the first six dilutions, repeated 
three or four times a day ; or in doses of the pellets, 
either dry or in solution, according to the severity and 
intensity of the symptoms, the susceptibility of the patient, 
and the judgment of the attending physician. 

In our opinion, the ordinary doses of the third and 
sixth potencies, repeated once in three or four hours, or 
once or twice a day only, according to circumstances, 

* Jahr's Venereal Diseases, p. 65. 

f Marcy and Hunt, Practice, II. p. 379. 

J Therapeutics, p. 195. 



GONORRHCEA. 29 

are abundantly capable of curing persons suffering with 
acute gonorrhoea ; provided they keep perfectly quiet, and 
observe a strict regimen in all respects. And to the too 
common plan of attempting to make the quantity of 
medicine compensate as well for want of scientific accu- 
racy on the part of the physician, as for neglect of the 
necessary regimen on the part of the patient, must often 
be attributed the disappointment which not unfrequently 
occurs to both. The Cannabis may sometimes prove 
an exception, and act more promptly and favorably in 
the mother tincture. 

But in most cases of gonorrhoea, even in the first in- 
stance, it will be well for the physician to consider with 
the utmost care what kind, if any, of psoric or other 
miasm may be latent in his patient's system, and admin- 
ister an occasional intercurrent dose of Sulphur, Sepia, 
Nat. mur., Merc, Thuja* or whatever other anti-psoric, 
anti-miasmic, anti-syphilitic, or anti-sycosic, he may think 
required by the subjective symptoms, present condition, 
and previous history. Nat. mur., for instance, will 
often be needed, and prove curative in recent as in 
chronic cases, where the patient has been exposed or 
subject to intermittents. According to Jahr, however, 
''it is only where intense inflammations threaten danger- 
ous results, such as gangrene, where Jr. seme would 
have to be used, that intercurrent remedies become neces- 
sary." 

The indications given here for the various remedies 
are unavoidably scanty and meagre ; they must be re- 
garded only as hints towards their thorough study in 

* On the great importance of Thuja, for example, as an inter- 
current remedy, consult Am. Horn. Review, Vol. III. p. 117. 

3* 



30 GONORRH(EA. 

the Materia Medica itself. And the more closely the 
practitioner assimilates his prescription to the actual 
condition of the individual patient, so much the more 
rapidly and perfectly will he cure him.] 

Aconite. This remedy is always to be employed as 
soon as the first symptoms arise, and is to be very fre- 
quently repeated, being extremely efficacious in conjunc- 
tion with Cannabis and Petroselinum in allaying the 
inflammation and subduing the discharge. 

Cannabis. Dr. Curie states that this remedy is only 
useful in the premonitory stage, when the discharge is 
thin, and not partaking of the purulent character, and 
also at the termination of the complaint when the secre- 
tion has lost its distinctive features. In gonorrhoea 
proper it is perfectly useless* Dr. Hempel gives the 
following indications: Discharge of pus from the urethra; 
ulcerative soreness of the urethra when^ touching it; diffi- 
culty of urinating, with constant urging ; sensation of 
tearing in the fibres of the urethra ; the urethra feels as 
if drawn up into knots. The glans may be sore, swollen, 
and inflamed. These symptoms may be accompanied 
with symptoms of vascular excitement, rush of blood to 
the head, frontal headache, &c. 

[The German Homoeopathic physician, Muller,f finds 
this remedy useful only in strong doses, the first or 
mother tincture ; and declares its value in gonorrhoea 

[* This opinion of Berjeau I prefer to let stand as he left it; 
the reader can compare it with the opinions and advice of other 
physicians as here given. — F.] 

f U. S. Med. and Surg. Journal, Vol. I. p. 160. 



GOINTORRHCEA. 31 

to be uncertain and trifling, — in which Dr. Holcornbe 
agrees. In my own experience, and in that of other 
physicians of my acquaintance, this remedy has proved 
very valuable, — not when prescribed by rote, but when 
homoeopathically indicated, which it so often is, that 
Jahr came to regard it as almost a specific in gonorrhoea. 
But we have no such general specifics ; what answers 
in one country or person, may not in another.] 

Argenti Nitras. This valuable remedy in purulent 
inflammations is indicated when the emission of urine is 
accompanied by burning, and sensation as if the urethra 
were closed, the last portion of urine remaining behind; 
with dragging pain and feeling of soreness in the ure- 
thra, cutting pain extending to the anus, haemorrhage, 
and discharge of pus from the urethra, and painful ten- 
sive erections. Also, when severe inflammatory symp- 
toms are present, with priapism, chordee, swelling of 
the penis, great febrile irritation, and sensation as if the 
urethra were drawn into knots. 

Petroselinum is very efficacious when there is tingling 
and pressure at the root of the penis, especially early 
in the morning whilst in bed, abating when standing 
or sitting, a milky fluid being secreted which can be 
pressed out, afterwards changing to a yellow glutinous 
matter. 

[Drs. Miiller and Holcornbe pronounce this remedy 
worthless in gonorrhoea, It has disappointed many 
others who have used it.*] 

* U. S. Med. and Surg. Journal, Vol. I. p. 167. 



32 GONORRHOEA. 

Mercurius corrosivus. When the orifice of the ure- 
thra is inflamed, and the fore part swollen with sup- 
puration between the glans and prepuce ; the glans 
being red, hot, and painful when touched, accompanied 
with burning pain, and itching, stinging, and throbbing 
in the urethra, the urine passing with a feeble stream ; 
the discharge is greenish, often painless, especially at 
night. 

Sulphur. When the patient is of a scrofulous consti- 
tution, or when other remedies apparently well selected 
do not appear to exercise any beneficial influence on the 
complaint, this remedy will be generally found very 
efficacious. Its more especial indications are, when, in 
addition to the discharge, there are burning pains near 
the orifice of the urethra, which is red and inflamed, with 
constant urging to urinate, accompanied with tearing 
and stinging, the stream of urine being thin and divided ; 
there is at times itching in the middle of the urethra, 
with stitches and cutting pains during stool. 

Hep. sulph. ; Silicea. These two remedies are very 
frequently useful in discharges of white, yellowish, or 
discolored pus, attended with a fetid smell, particularly 
when occasjoned by scrofulous leucorrhoea. 

Agnus castus. When the inflammatory symptoms 
have subsided, but a yellow purulent discharge remains, 
and there is absence of sexual desire and want of erec- 
tion, Agnus will render efficient service. 

Cantharis. This medicine, although principally used 
in secondary gonorrhoea, when the discharge again in- 
creases, is frequently required in primary cases, partic- 
ularly should the inflammation threaten to extend to the 



GONORRHCEA. 33 

bladder. Burning pains of excoriation, with yellow or 
sanguineous discharge, which stains the linen, and great 
difficulty and pain in making water, especially point to 
this remedy. 

Capsicum. Pricking, burning, cutting pains, with 
sensation of warmth in the urethra, excessive sensibility 
of the parts to contact, and thick, purulent, yellow dis- 
charge, indicate Capsicum. 

Cocculus is useful when there is tensive aching pain 
in the orifice of the urethra, when not urinating. 

Copaiba. This well-known remedy should be taken 
when the discharge is purulent, with a painful soreness, 
and continual smarting, itching pain, with swelling of the 
urethra. A very characteristic indication for Copaiba 
is a violet smell of the urine ; or when the discharge is 
accompanied by a cutaneous eruption like measles or 
nettle-rash attended with great itching. 

Cubebae is useful when the discharge is dark and red- 
dish as if mixed with blood, the urine having a violet 
odor. 

Mezereum. The discharge in this case is watery 
mucus, increased by exercise, and the pain stinging and 
titillating, through the whole course of the urethra, ex- 
tending to the perinaBum, with painful soreness of the 
urethra when touched. 

Millefolium. In severe eases with swelling of the 
penis, and discharge of blood and watery slime, this 
remedy (or in alternation with Cantharis) is indispen- 
sable. 

Nux vomica. Pressive pains occurring at the orifice 
of the urethra when not urinating, accompanied with 
shuddering, and sharp pains as of a cutting instrument 



34 GONORRHOEA. 

near the orifice of the passage, the bladder, the perinseuni, 
or anus as from flatulence, with discharge of mucus, and 
often accompanied with hemorrhoidal affections. 

Pulsatilla. Suppressed gonorrhoea, -with swelling of 
the testicles, contraction of the passage, and discharge 
of dark-colored blood, with tendency to inflammation of 
the eyes, particularly in mild-disposed persons, with light 
hair. 

[Tussilago petasites. — Butterbur, Pestilent-wort — 
First recommended in gonorrhoea by C. H. Rosenberg.* 
" The remedy, considered by the people of Baden as in- 
fallible against gonorrhoea, was nothing more than the 
water containing the plant in a macerated condition." 
Dr. Rosenberg gave about one teaspoonful of the water 
for a dose, morning and evening ; and cured twenty-six 
cases with it in from two to four weeks 7 treatment. The 
active properties of this plant may not be entirely taken 
up by alcohol ; water alone dissolving some of the muci- 
laginous and other elements common to aquatic plants. 
From this may result the low esteem into which this 
once celebrated remedy is now fallen. 

Indications : " Acute stage, fixed, stinging pain in the 
fossa navicularis ; for persons of high living and irregu- 
lar habits. Chronic stage, with inflammation of the eyes 
and swelling of the testicles, after suppressed discharge." 
Raue.f] 

Thuja. Required when the discharge is watery and 
copious, with drawing, cutting, burning, piercing pains, 

* Homoeopathic Examiner, New Series, Vol. I. p. 251. 
j- Pathology and Therapeutics, p. 381. 



GONORRHCEA. 35 

especially when walking, and stitches in the urethra 
when not urinating. 

Colchicum is very useful when, with scanty emission 
of dark albuminous urine, there is continual urging tp- 
urinate, and burning pains in the urethra; the urine de- 
positing a whitish, or purulent flocculent sediment. 

Carbo veg. is likely to prove useful, when there are 
violent burning pains in the urethra, and extremely of- 
fensive discharge. 



GONORRHOEA. —SYMPTOMATIC INDICATIONS. 

N. B. The symptoms in this list belong to the Urethra, unless 
specially noticed. 

Aching at the orifice, with shuddering . Nux vomica. 

with pressure, as from matter in the 

fore part .... Cannabis. 
Biting pains in the fore part . . . Cann., Copaib., Ar- 

senicum. 
Burning pains ..... Bry., Canth., Con. y 

Thuja. 
with itching before and after urinating Apis melt., Copaiba. 
at the orifice .... Capsicum. 
with soreness of the prepuce . . Cinchona. 

in the middle of the passage when not 

urinating .... Staphysagria. 
during urination, with feeling of swell- 
ing . . . . . Argent, nitras. 
and stitches (also on the glans and ex- 
ternal part of the prepuce) . . Cannabis. 
itching, and stitches in the fore part 

when not urinating . . . Bryonia. 

Contraction of the passage . . . Bry., Puis., Sulph. 

Contractive pains extending backwards . Nux vomica. 

Drawing, stitches, and discharge of moisture . Mezereum. 
Crawling, in the morning in bed . . Petroselinum. 

then aching .... Petroselinum. 
tickling and itching . . . Cinchona. 



36 GONORRHOEA. 

Crawling, when moving, especially in the even- 
ing .... Thuja. 
Cutting, when not urinating . . . Capsicum. 
pains, continual . . . Cantharis. 
whilst passing the last drops of 

urine .... Arg. nitras. 
and burning after urinating, with dis- 
charge of mucus. . . . Natri murias. 
before and after stool . . . Sulphur. 
and drawing whilst walking . . Thuja. 
Drawing pain and tearing in the fore part . Bryonia. 

extending back to the anus. . . Acid, phosph. 

and tearing from perinseum, through 

the whole urethra . . . Mezereum. 

and aching at the root of the penis . Petroselinum. 
Inflammation of the orifice . . . Merc. , Sulph. 

with throbbing . . . Copaiba. 

and pain in entire course . Sabina, Cannabis. 

with violent pain, increased dis- 
charge, erections, anddysuria . Argent, nitras. 
Itching in the fore part of the urethra . . Ign., Am., Merc. 

almost agreeable . . . Cannabis. 

and stinging in the fore part . . Cocculus. 

Pinching when not urinating . . . Jferatrum. 

during urination . . . Argent, nitras. 

Soreness of the orifice .... Copaiba. 

internal, continuing after urination . Arg. nitras. 
painful, at the orifice . . . Ac. nitricum. 

on pressure .... Natr. mur., Mezer. 
Stitches, in the urethra .... Apis., Am., Cocc, 

Sulphur. 
painful at the orifice . . . Acid, phosph. 

in the fore part . . . Sulphur. 

when not urinating . Acid phosph. 
ending in tearing pain . Ignatia. 
along the urethra when not urinating Cannabis. 
from behind forwards . . Thuja. 

back through the urethra . . Mercurius. 

after frequent erections . . Cannabis. 

entering the abdomen . . . Mercurius, 

whilst at stool .... Scilla. 
dull, during movement, when not uri- 
nating .... Belladonna. 
vehement, deep in the urethra, whilst 

walking .... Ignatia. 

strong, when not urinating . . Capsicum. 



GONORRHCEA. 37 

Stitches, violent, extending its whole length . Conium. 
twitching, in the back part when 

standing .... Cannabis. 
tearing in the fore part of the urethra Thuja. 
itching and tickling, in the fore part 

of the urethra . . . Cannabis. 

transient, with bleeding . . Arg. nitras. 

Stinging, when not urinating . . . Acid phosph. 

as with a needle . . . Capsicum. 

occasionally dull . . . Mercurius. 

twitching and cutting, when not uri- 
nating .... Thuja. 
changing after urinating into a cutting 

and biting .... Petroselinum. 
corrosive, and burning . . Cannabis. 

Swelling of the urethra .... Rhus., Ac. nitric. 
with throbbing pain . . . Copaiba. 

with hard and knotty feeling . . Arg. nitras. 

Tearing, or rending, in the fore part . . Antim. tart. 

and drawing when not urinating . Bryonia. 

through the whole urethra to the peri- 

ngeum .... Mezereum. 

in a zigzac form, as if in the fibres of 

the urethra .... Cannabis. 
and in the rectum, when not urinating Ruta. 
deep in the urethra . . . Arsenicum. 

with dull stitches . . . Aurum. 

and stinging, when not urinating . Sulphur. 
Throbbing pain ..... Copaiba, Merc, 

Hepar. 
in the region of the bladder . Cinchona. 

Twitching pain in the urethra . . . Thuja. 

as in the emission of semen . . Petroleum. 



CHARACTER OF THE DISCHARGE. 

Discharge of bad-smelling moisture . . Pulsatilla. 

bloody slime .... Ac. nitr., Millefol. 

in drops . . Pulsatilla. 

green, and painless during the night Mercurius. 
increased .... Canth., Argent.nit. 
of milky moisture . . . Petroselinum. 

mucous, after a chill (milky white- 
ness) .... Ferr., Capsicum. 
of pus .... Copaiba. 
4 



38 GONORRHOEA OF THE FEMALE. 

Discharge semen-like, with burning pain after 

urination .... Pulsatilla. 
slimy without pain . . . Cann., Petroleum. 

thin, mucous, which leaves stiff spots 

on the linen . . . Natri murias. 

thin at first, afterwards thick, with 

biting pain during urinating . Mercurius. 
varnish-like .... Petroselinum. 
watery and slimy . . •. Cann., Thuja. 

white, acrid, muddy matter with 

mucus .... Sarsaparilla. 
yellowish, which stains the linen . Canth., Agnus cast. 
yellow and thick . . . Capsicum. 

fetid and discolored . . Silie., Carbo veg. 

of whitish or yellowish pus . . Hep. sulph., Gale. 



GONORRHOEA OF THE FEMALE. 

Besides leucorrhcea, which is generally a non-syphilitic 
disease, women are subject to gonorrhceal inflammation, 
which, owing to the large extent of mucous membrane of 
the parts, is generally accompanied with a much greater 
discharge. This discharge may proceed from the urethra 
(which, being very short and dilatable, does not produce 
such distressing effects as in men), the labia majora and 
minora, or from the vagina or uterus. In order to dis- 
tinguish the nature of the discharge and the seat of the 
affection, the speculum is indispensable. If the inflam- 
mation has its seat in the urethra, it is revealed by itching 
pain, swelling of the orifice of the urethra, urging to 
urinate, with scalding pain during micturition, and sym- 
pathetic inflammation of the. labia and vagina. Drops of 
pus are seen at the orifice of the urethra, the linen is 
stained with isolated opaque spots of a yellowish-green 



GONORRHCEA OF THE FEMALE. 39 

color, which may be pressed out by introducing the 
finger into the vagina, and compressing the urethra from 
behind, forwards and upwards. If the labia are affected, 
the inflammation is the same as the balanorrhoea of the 
male, the internal labia constituting a thick, bluish-red, 
shining, disc-shaped swelling, and covered with erosions, 
whilst the labia majora are tense, darkish-red, and ver} r 
prominent ; the urine in its passage causing much pain, 
the introduction of the speculum being impossible. If 
the inflammation is great, the warmth of the bed becomes 
intolerable, febrile symptoms arise, and the patient is 
tormented by thirst and sleepless nights ; a viscid puru- 
lent fluid, of a specific odor, is secreted, and often dries 
up in the hair of the pudendum, forming a thick crust, or 
else flowing down, excoriates the neighboring parts. Cor- 
pulent females seem to be more particularly predisposed 
to this kind of gonorrhoea. 

Vaginitis (inflammation of the vagina) is more fre- 
quently met with than the affection of the external parts, 
although it is commonly accompanied with blennorrhea 
of the labia ; when severe, the whole mucous membrane 
and the subjacent cellular tissue are involved, the heat 
in the vagina is intense, and the pain, increased by any 
exertion, frequently extending to the kidneys ; the sexual 
desire is also more intense, and mucus or pus is dis- 
charged profusely. If the follicles of the vagina are 
principally invaded, a number of miliary granulations 
may be distinguished with the finger. The mucous 
membrane is redder than usual, partially denuded of its 
epithelium, and covered with small superficial ulcers. 
The discharge is frequently mixed with blood, has an 
acid reaction, and leaves yellow or yellowish-green 



40 GONORRHOEA OF THE FEMALE. 

stains on the linen. When the inflammation extends to 
the uterus, the disease becomes much more intractable. 
Then we have violent haemorrhage, with great disturb- 
ance of the menstrual functions, and if the woman is 
pregnant, a tendency to miscarriage, or even degenera- 
tion of the foetus ; in severe cases, complete obliteration 
of the Fallopian tubes and incurable sterility are pro- 
duced. This disease can only be properly recognized by 
means of the speculum, which reveals the neck of the 
uterus, dry and red, and covered with whitish, thick, 
adhering mucus, secreted from the neighboring parts ; 
the patient complains of heaviness and drawing in the 
pelvis and small of the back, and frequently experiences 
burning pains when sitting down. The parts around 
the mouth of the womb are covered with erosions, and 
the inflammation often spreads to the inner surface of 
the uterus, the Fallopian tubes, and ovaries, and even 
to the peritoneum. 

Treatment. — The best remedies for urethritis are 
Cannabis and Thuja; for vulvitis, Bryonia, Mercurius, 
Sabina, and Thuja; for vaginitis, Bellad., KreosoL, 
Lycop., Mercurius, Nux vom., Puis., and Sabina; for 
uteritis, Ac. nitric, Canth., Ignat., Phos., and Platina. 
The seat and extent of the disease being ascertained, the 
selection of one or several of the following medicines, 
either alone or in alternation, will be greatly facilitated 
by the comparison between the symptoms of this com- 
plaint and those of gonorrhoea of the male. 

Aconite is always to be resorted to in cases attended 
with inflammatory symptoms, with great heat, and 
scalding in making water. 

Arsenicum should be given when there is smarting, 



GONORRH03A OF THE FEMALE. 41 

gnawing discharge, causing soreness of the parts with 
which it comes in contact ; when standing, the discharge 
drops down, accompanied with emission of flatulence; or 
when there is also great redness of the parts. 

Aurum is useful for profuse discharge which excoriates 
the perineum and inner parts of the thighs, with vesicular 
eruptions on the parts, or when labor-like pains are present. 

Belladonna is required for discharge of white mucus 
from the vagina, with violent stitches in the pubic re- 
gion and the inner parts, with violent dragging- pains, 
as if everything would issue from the abdomen. 

Bryonia is good when the discharge, which had pre- 
viously much decreased, again increases, attended with 
swelling of the labia, and sometimes with black, hard 
pustules, which arise on the swollen parts. 

Calcis carb. should be given for burning, milky dis- 
charge, attended w T ith pressure on the vagina, and tuber- 
cles on the labia. 

Cannabis should be preferred when there is cutting 
pain between the labia during micturition, the orifice 
of the urethra also being closed with pus, there being 
violent sexual desire, with swelling of the vagina. 

Cantharis is to be prescribed when there is copious 
debilitating discharge, and pains in the kidneys, with 
distressing sensations in the pelvis, accompanied with 
a languid, sallow complexion, and depression of spirits. 
It is also useful in swelling of the neck of the womb, 
with burning and itching of the genital parts. 

Chamomilla is more especially useful for yellow, smart- 
ing discharge from the vagina, or for acrid, smarting, 
watery discharge, with smarting burning, as if the parts 
were excoriated. 
4* 



42 GONORRHOEA OF THE FEMALE. 

Ignatia is good for violent, cramp-like pressure on the 
uterus, followed by purulent corrosive discharge, with 
swelling of the clitoris, and weakness of the remainder 
of the genital organs, sometimes attended with uterine 
spasms. 

Kreosofum is of great utility in bloody, salmon-colored, 
yellow, or yellowish-white discharges, having a foul odor, 
especially in the morning ; or in acrid discharges, with 
itching of the parts, or jerking, smarting pain in the ex- 
ternal parts, with weakness in the legs. 

Lycopodium is of great service in copious bloody and 
milky discharge, with burning in the vagina. 

Mercurius is of great service when there is discharge 
of flocks, pus, and mucus, or purulent discharge of a 
greenish color, which does not drop, causing a smarting 
in the anterior portions of the genital parts; or when 
there is corrosive discharge, with long-tasting itching of 
the labia, especially just before the menses, and swelling 
of the follicles of the labia, with pressing in the parts, 
causing the patient to void a quantity of urine. It is 
also good when the vagina is swollen and inflamed, with 
a feeling of rawness and soreness. 

Nux vomica is very appropriate for painless discharge 
of yellow mucus from the vagina ; or for fetid mucus, 
with burning in the parts, and violent sexual desire ; or 
for gnawing, itching eruptions on the genitals, and swell- 
ing of the inner portion of the vagina, with burning pain, 
the slightest touch causing intolerable distress. 

Nitric acid is invaluable in discharge of flesh-colored 
mucus, one-half of the vagina being swollen, with flat 
ulcers on the inner parts, apparently covered with pus, 
causing burning, itching pain. 



GONORRHCEA OF THE FEMALE. 43 

Phosphorus is very useful in mucous or milky dis- 
charge, with stitches through the whole length of the 
vagina, and great aversion to sexual intercourse. 

Platina. In mucous discharge, with pinching in the 
abdomen, followed by pressing downwards in the groins 
and discharge of blood, this remedy is very useful. . 

Pulsatilla is very efficient in painless discharge of thick- 
ish. milky mucus, which is especially perceptible on lying 
down, with burning, stinging pain and swelling of the 
labia, and cutting pains at the mouth of the uterus. 

Sabina is to be given in discharge of blood and mucus, 
or yellow, ichorous, fetid secretion, which frequently re- 
curs, with itching and stitches in the vagina. 

Sepia is requisite w T hen blood is discharged w T hen walk- 
ing, and with mucous discharge and itching of the genital 
organs. 

Sulphur. Violent itching of the clitoris, and burn- 
ing of the exterior parts, accompanied with vesication, 
attended with smarting, burning, thin discharge, espe- 
cially in the morning. 

Thuja is of importance when both labia sw T ell and are 
covered with whitish ulcers, the discharge from the ure- 
thra being yellow or green mucus or pus, which stains 
the linen, and attended with smarting and itching, espe- 
cially when urinating ; walking produces stinging, itch- 
ing, and smarting pain, with contractive and pressing 
pain in the genitals. 

[In recent or chronic cases of gonorrhoea, characterized 
by cauliflower excrescences, or by condylomata, this 
remedy will be indispensable.] 

Zincum should be preferred when there is a discharge 
of thick mucus, especially after stool, with constant pinch- 



44 GONORRHOEA OF THE FEMALE. 

ing and yawning previous to the discharge. The sexual 
desire is also very excited, especially at night, but with- 
out lascivious dreams. 

[In gonorrhoea of the female it is indispensably requi- 
site that the patient entirely abstain from sexual inter- 
course, and observe the strictest diet, not only during 
treatment, but even for some time after the cure is ap- 
parently complete. Jahr says : " From a single cup of 
coffee, or from a single coit, I have seen the discharge 
return worse than ever, even after it was all but stopped." 
And this is amply confirmed by the experience of others. 
The greatest difficulty in curing the female patient, as 
in the male, consists in maintaining, in all respects, the 
necessarily rigid diet and regimen, — such as is involved 
in abstinence, from exposure to cold, sexual excitement, 
walking or other physical exertion, and from every va- 
riety of hearty food and stimulating drink. The best 
medical treatment, the most accurate prescriptions, will 
prove ineffectual, if the patient do not observe these 
strict rules ; and the physician will be unfaithful alike 
to his patient and to himself, who does not impress them 
in all their importance upon the mind of the former. 
While, if the physician prescribe correctly, he may 
always take it for granted, when a relapse or aggra- 
vation of the disease occurs, that the cause for it (and 
without some particular cause it cannot occur) must be 
found in some transgression on the part of the patient. 
And it will be needful, by strictly interrogating the pa- 
tient, to discover what this transgression has been, in 
order both to remedy its effects and to prevent its recur- 
rence in future. 



GONORRHCEA OF THE FEMALE. 45 

The medical treatment which may be required in the 
female suffering from gonorrhoea, is not very different 
from that indicated in the male ; but the cure is often 
more readily effected. In the first stage of the acute 
form, Aconite will be needed ; then Cannabis, or what- 
ever other remedy is most strongly called for by the 
prevailing symptoms and conditions. Jahr says : " We 
depend upon Cannabis as our chief remedy in the treat- 
ment of simple acute gonorrhoea (in the female) ; this 
remedy will effect a cure, in most cases, in the space of 
two or three weeks, provided its use is persisted in and 
the patient abstains from all improper dietetic indul- 
gences." 

In the chronic form, or gleet, which greatly resembles 
ordinary leucorrhcea,* Sepia will often be required. 
Where there is reason to suspect the presence of syphi- 
litic virus in the system, Mercurius, or some other anti- 
syphilitic, will be necessary. If the patient has been 
mercurialized already, Nitric acid should receive partic- 
ular attention; also Phytolacca decandra ; — whatever 
anti-syphilitic and anti-mercurial best corresponds with 
the prevailing symptoms, should be carefully admin- 
istered. The most remarkable characteristic indication 
for Thuja, condylomata, or fig-warts, on vulva or anus, 
Berjeau has omitted. In addition to the other remedies 
mentioned by him, the following should be considered : 
Alumina, Causticum, Conium, Iodium, Lachesis, Sarsa- 
parilla. Compare also the remedies mentioned for gleet 
in the male.] 

* See an admirable resume" of Indications for Medicines in 
Leucorrhcea, by Dr. Guernsey ; Hahnemannian Monthly, March 
and February, 1869, Vol. IV. p. 293. 



46 GONORRHOEA OF THE FEMALE. 



SYMPTOMATIC INDICATIONS. 

Acrid discharge, with itching of the parts . Kreosotum. 
smarting watery discharge from the 

vagina ..... Chamom'dla. 

Black, hard pustules on the labia . . Bryonia, 

Bloating of the abdomen, followed by contrac- 
tion ...... Belladonna. 

Burning and itching of the pudendum . . Cantharis. 

in the vagina, with copi- 
ous bloody or milky dis- 
charge . . . Lycopodium. 
stinging pain in the labia and vagina . Pulsatilla 
Coolness of the body, with uterine spasms . Ignaiia. 
Cramp-like pressure in the uterus, followed by 

corrosive purulent discharge. . . Ignatia. 

Cutting between the labia during micturition . Cannabis. 
Cutting pain at the orifice of the womb in va- 
ginitis ..... Pulsatilla. 

Discharge of white mucus from the vagina . Belladonna. 
increased, after having decreased . Bryonia. 
causing smarting of the parts which 

it touches .... Cannabis. 

of blood, with sexual excitement . Sabina. 
of pus, or flocks, with scalding . Mercurius. 
acrid, fluid, corroding the parts . Are., Kreos., Aur. 
milky fluid .... Calc, Lye, Phos., 

Pulsatilla. 
Dragging towards the sexual parts, with stitches 

in the pubis ..... Belladonna. 

Fetid mucous discharge from the vagina . Nux vomica. 

Gnawing, itching eruption on the pudendum . Nux vomica. 
soreness on the left side of the puden- 
dum ..... Platina. 

Greenish discharge, with itching of the parts . Nat. murias. 
Itching of the labia, with corroding discharge . Mercurius. 

sexual organs . . . Sabina, Sepia. 

vagina, with watery discharge . Sepia. 
Milky discharge early in the morning . . Phosphorus. 

or opalescent discharge, with smarting . Acid, sulph. 
Mucous discharge from the urethra and vagina Mezer., Thuja. 

and bloody discharge from the vagina . Sabina. 
Pale yellow nauseous discharge from the vagina Merc, corros. 
Painless discharge of yellow mucus from the 

vagina ..... Nux vomica. 



GLEET. 



47 



Purulent greenish discharge, causing smarting Mercurius. 
Redness of the parts, with smarting, gnawing 

discharge ..... Arsenicum. 

Stinging pain in the pudendum when walking . Thuja. 
Sharp stitches in the posterior part of the va- 
gina ...... Sabina. 

Smarting, burning, thin discharge . . Sulphur. 

and itching in the urethra, 

when urinating . ' . Thuja. 

Swelling of the labia majora . . . Bryonia. 

vagina, with violent sexual de- 
sire .... Cannabis. 

and inflammation of the vagina . Mercurius. 

of the neck of the uterus . . Cantharis. 

clitoris .... Ignatia. 

follicles of the labia . . Mercurius. 

vagina, which is excessively 

sensitive . . . Nux vomica. 

of both labiae, with burning pain . Thuja. 
Thickish milky mucous discharge . . Pulsatilla, 

Transparent mucus, with smarting pain . Stannum. 

Tubercles on the labia .... Cal. carb. 

Vesicular eruption on the parts . . Aurum. 

Violent itching of the clitoris . . . Sulphur. 

Whitish ulcers on the labia majora . . Thuja. 

Yellow, smarting discharge from the vagina . Chamomilla. 
or yellowish-white fetid discharge . Kreosotum. 
discharge, with sickly sweetish odor . Mercurius, 
excoriating discharge . . . Sulphur. 



GLEET. 



This is a morbid discharge of a muco-purulent, serous, 
or pale-green fluid from the urethra, without inflam- 
matory symptoms, or rather without pain and heat in 
urinating, and is generally a sequel to acute or misman- 
aged gonorrhoea. This discharge arises after the acute 
symptoms of the former affection have disappeared, 



48 GLEET. 

threading between the fingers, staining the linen but 
slightly, and if neglected continuing for months, or even 
years, without any other bad symptom than that it sen- 
sibly weakens the constitution of the patient ; at other 
times, however, it may produce stricture, or even affec- 
tions of the prostate gland, bladder, or the kidneys. In 
particular cases, although the discharge may have ceased 
for weeks, it will reappear after connection, violent ex- 
ercise, or excesses of the table. The cause of the com- 
plaint is either ulceration of the mucous membrane of 
the urethra, or erosion of the orifices of the ducts of the 
prostate gland or seminal vessels, or from debility of the 
membrane itself. In the former case, the discharge is 
either of pus, or mucus mixed with pus ; in the latter 
cases, it is limpid, mucous, copious, persistent, and at- 
tended with a peculiarly nauseous smell. 

Strict attention to diet, for a considerable time after 
every trace of the complaint has disappeared, is neces- 
sary, as even slight excesses have a tendency to cause a 
return of the abnormal symptoms; cleanliness also should 
be strictly observed. 

Treatment. — When the disease is seated within a 
short distance of the orifice of the urethra, it is generally 
easily cured ; but if the seat is in some gland of the ure- 
thral canal, or there is ulceration of the passage, or ero- 
sions of the seminal ducts, it is much more intractable, 
and in such cases considerable quantities of fluid should 
be taken, in order to dilute the urine, and prevent irri- 
tation of the part. 

Cannabis is very useful when the discharge is thin and 
watery, of a greenish or yellow color, and disagreeable 
odor, 



GLEET. 49 

Capsicum is more required when the discharge is muco- 
purulent, with a tendency to spermatorrhoea, or when it 
has become yellow, or whitish and thick. White dis- 
charge, like cream. 

Ferrum. This is a most important remedy in mucous 
gleet, arising from debility of the vessels after severe 
gonorrhoea. Painless discharge, like milk. 

Kali bichrom. should be given when the discharge is 
stringy, or jelly-like, and rather profuse. 

Merc, corros. This medicine is required when ulcer- 
ation is suspected, and the secretion is purulent or bloody, 
of a greenish, yellowish, or whitish consistence. 

[Mez. — Gleet. A drop of a gluey, albuminous liquid 
appears at times at the orifice of the urethra.] 

Acid nitric is useful in similar symptoms, particularly 
when Mercury has been previously employed without 
benefit. 

Nux vomica. This remedy can be employed when 
the patient is subject to piles, and the discharge is prin- 
cipally clear mucus; it is of great service when the com- 
plaint has been aggravated by excess in diet, or the use 
of beer or strong drinks. 

Sepia. In chronic, intractable cases, where the dis- 
charge is milky, or greenish, attended with pain in the 
back. 

[As already stated, a few doses, or even a single dose, 
of the appropriate antipsoric may be made to cure the 
most inveterate case of gleet. According to Jahr, 
" Gleet is generally nothing more than a symptom of 
weakness of the mucous lining, which had been occa- 
sioned by this disorder,' 7 (Gonorrhoea.) But it seems 
5 



50 GLEET. 

impossible to believe that this simple and apparently 
trifling difficulty can be all, — when for months, and even 
years, it bids defiance to mild treatment, to stimulating 
and tonic treatment, to all sorts of treatment in fact, 
save and except the minute doses of the true antipsoric 
which the particular constitution of the patient requires, 
and under the influence of which it is often seen to fade 
away, like dew before the sun. 

In order to recover from this disorder, it may be neces- 
sary for the patient to abstain entirely from malt liquors, 
as well as from spirits. And it is believed that in some 
cases the habit of smoking suffices to keep up the irrita- 
tion and consequent discharge. This discharge, although 
so minute, when long established, becomes the outlet, or 
at least the representation, the coefficient, of all that is 
morbid in the system, or wrong in the person's habitual 
life. By aiming at the entire system of the patient, the 
physician will soon cure his gleet ; but by directing his 
attention to the gleet alone, he will as surely not cure the 
one or the other ! Yerbum sat. 

Ferrum, Phosph., and Sulphur, are all the remedies 
mentioned by Jahr in this connection. Each one of 
these is capable of curing many cases, for it will be 
indicated in many ; but not in all. 

C. Miiller writes : "In chronic gonorrhoea, I have seen 
good results from nat. mur. This remedy is recom- 
mended especially after injections of Nitrate of Silver." 

Sepia will often be called for. " Sepia and Silicea 
have frequently cured long-lasting gonorrhoea! dis- 
charges.'' 

Cimicifuga racemosa is said by Hale * to cure old 
standing oases of gleet and spermatorrhoea. 
* Materia Medica of New Remedies, 



GLEET. 51 

Gelseminum; JErigeron; Phytolacca dec. ; and Podo- 
phyllin, (the latter in females especially,) and others, 
have been recommended in gleet. 

Riickert* advises also Cubebs, and Lycopodium, in 
addition to other medicines. 

From Raue f we glean also the four following reme- 
dies : — 

Agnus c. Gleet : yellow purulent discharge, impotence. 

Fluoric acid. Gleet : little discharge during the night, 
which makes a yellowish stain on the linen. 

Phosph. acid. Gleet : every morning a few drops of a 
white discharge from the urethra, and in the evening 
discharge of prostatic juice. 

Phosph. Gleet : every morning a drop of watery fluid 
at the orifice of the urethra, sticking its lips together. 
Compare Mezereum. 

The indications for these and other remedies in this 
complaint, might be extended almost indefinitely; but 
we content ourselves with remarking, that, whatever 
medicine is indicated by the totality of the symptoms of 
the patient, by his dynamic, constitutional conditions, 
will prove curative. For not the discharge only, or indeed 
even principally, but all the accompanying affections and 
recent or latent complications, must be considered and 
provided for. This is what we mean by prescribing 
for the patient, and not for the gleet alone.] 

Sulphur is very efficacious in this complaint, either in 
the mucous or purulent variety, and is to be employed 
when the previous remedies seemingly exert no beneficial 

* Therapeutics, p. 196. 

| Pathology and Therapeutics, p. 380. 



52 BALANORR(EA. 

influence, or the patient is of an unhealthy, or scrofulous 
disposition. 

Thuja. This remedy is useful in copious watery dis- 
charges from the urethra, and particularly when compli- 
cated with condylomata (warts). 

[For other remedies and indications in gleet, see pre- 
vious discussion of acute and chronic gonorrhoea.] 



BALANORRHCEA, Balanitis. 

This is an inflammatory disease, accompanied with 
purulent secretion from the surface of the glans, arising 
principally from gonorrhceal infection ; however, some 
irritating and non-contagious cause m&y produce inflam- 
mation of this part, and even a purulent secretion from 
the follicular glands which surround the corona glandis. 
This disease frequently occurs in children. It is neces- 
sary, however, to observe, that the strong-smelling sub- 
stance which is secreted and accumulates behind the 
glans, when the prepuce is not frequently retracted, is 
not to be confounded with balanorrhcea, as it can easily 
be cured by a little attention to cleanliness. Contagious 
balanorrhcea shows itself sometimes in a few hours, or in 
most cases from three to six days after impure con- 
nection. 

General Symptoms. — The first symptoms are a slight 
smarting or burning on the surface of the glans, which 
becomes hot, and of a bright rosy, or carmine color, 



BALANORRHCEA. 53 

somewhat swollen, and sensitive to pressure or the fric- 
tion of the clothes. The secretion of the follicular glands 
becomes purulent, thick, greenish or yellow, and is dis- 
charged on each side the fraenum in large tenacious drops, 
which dry up, and cause the glans to adhere to the linen : 
inside the prepuce, its folds are filled with pus, forming, 
as it dries, small crusts of a dirty yellow color. The 
surface of the glans, and the skin of the prepuce itself, 
become covered with erosions, arising from the acrid 
nature of the secretion ; these erosions form little flat 
ulcers, which sometimes remain unchanged for a fort- 
night, after which the cure proceeds rapidly, provided 
no violent incidental affections, as phimosis or paraphi- 
mosis, are induced by the extension and spreading of the 
ulcers. 

Prophylactics. — The use of strong soap and water 
after sexual intercourse will speedily remove the pus, 
which has a tendency to attach itself firmly to the cov- 
ering of the glans, and which water alone is unable to 
effect. 

Diet. — The same diet is to be observed as in gon- 
orrhoea. 

Acid nitric, is indicated when small vesicles form at 
the orifice of the urethra, on the inner surface and 
margin of the prepuce ; or when brown, painful spots, 
the size of a pea, arise on the glans or for flat little 
ulcers, which secrete a fetid matter and bleed when 
touched, accompanied with sharp stinging pains on the 
inner surface of the prepuce. 

Cannabis is to be preferred when bright red spots 
spread all over the glans, which is of a deeper hue than 
5* 



54 BALANORRHCEA. 

the prepuce itself, the back of the glans being red and 
damp, with itching at the fraenuin and under the pr& 
puce, the penis being swollen, whilst there is constant 
burning of the glans and prepuce. 

Capsicum is required when there is constant pressure 
and prickling in the glans, or when there is stinging and 
itching, as if the glans were bitten by fleas. 

Cinchona must be given when there is burning in both 
glans and prepuce, with sensation of creeping in the 
urethra, and fine prickling near the fraenum; or when 
there is itching of the glans, especially in bed, walking 
producing twitching in both glans and prepuce ; or tear- 
ing pains are also felt in the left side of the prepuce, and 
in the left testicle. 

Cinnabaris is necessary when, in addition to the burn- 
ing, stinging, or itching of the glans, there is a secretion 
of pus, of a nauseous sweetish smell, — or for small red 
spots on the glans, with little red shining spots or easily 
bleeding warts on the prepuce. 

Mercurius is more particularly indicated when there is 
inflammatory swelling of both glans and prepuce, with 
purulent secretion between the surfaces, and accom- 
panied with voluptuous itching, tingling, tearing, and 
shooting in both ; there is often an eruption of vesicles 
on the inner surface of the prepuce, which give rise to 
small ulcers, which itch and sting if pressed or rubbed ; 
the urethra being red, hot, and very painful when 
pressed. 

Mezereum should be administered when the secretion 
from the glans is very abundant, with tearing and burn- 
ing lancinations, soreness and excoriation of the parts, 
and inflammatory redness of the prepuce. 



BALANORRHCEA. 55 

Nux vomica is requisite when there is tickling, smart- 
ing, and itching of the glans and prepuce, which is re- 
tracted and excoriated, the secretion behind the glans 
being very copious, and the irritation being worse to- 
wards evening. 

Acidum phosphoricum is useful when there is a feeling 
of heaviness, and shooting pains in the glans, with tin- 
gling, oozing vesicles round the fraenum. 

Pulsatilla can be given when the tickling and itching 
of the glans and prepuce become worse towards morn- 
ing and evening, or when sitting, the irritation being 
sometimes accompanied with loss of prostatic fluid. 

Sabina. When there is deep redness of the glans, 
with great sensibility of the prepuce, with swelling and 
tightness of the frsenurn, continual shootings in the glans, 
and burning soreness when touched. 

Sulphur is required when there is icy coldness, and 
swelling, with redness of the glans, the prepuce being 
stiff and hard, attended with shooting pains, the secre- 
tion at the same time being very profuse. 

Thuja is needful should there be swelling of the pre- 
puce, with burning, itching, and feeling of soreness in 
the glans, which is covered with red spots or erosions, 
or small red, flat, unclean ulcers, with burning pain, or 
when there are violent stitches in the glans near the 
urethra. 



SYMPTOMATIC INDICATIONS. 

Aching and prickling, constant, especially at 

night and morning .... Capsicum. 

Biting ...... Nux vomica. 

and itching under the prepuce . . Pulsatilla. 



56 



BALANORRHCEA. 



Burning, with tickling, crawling, and aching 
in the urethra and anus 
about the glans in the evening, when 
small vesicles appear on the inner 
surface of the prepuce, and break 
into minute ulcers . . 

and itching at the back of the glans . 
and feeling of soreness 
with sore pain, felt continually 
and numerous stitches 
prickling, and itching at the end of 
the glans .... 

cutting, with outward pressing pain 
in groin .... 

Coldness, icy, of both glans and prepuce 
Contraction, and constrictive pain, at the back 
of the glans 
and wild sensitive pains in left 
groin, suddenly darting through 
the whole urethra 
and spasmodic pain 
Drawing and tearing at the corona glandis, 

with yellowish secretion 
Heaviness, feeling of, during micturition - 
Itching ...... 

in the morning .... 

with biting 
voluptuous, at the end of the glans 

at the fore part 
and biting under the prepuce . 
with crawling on the corona glandis 
painful, in the furrow at the back of 

the glans 
frequent . 
Prickling 

on the side of the glans 
when pressed . 
violent, in the morning 
and fine itching 
many fine itching stitches on the point 
of the glans 
Redness, dark . 

of both glans and prepuce 
with moisture on the glans 
Swelling, with moist eruption on the scrotum . 
bluish -red, of the glans, with fis- 
sures 



Cinchona. 



Mercurius. 
Nux vomica. 
Thuja. 
Sabina 
Thuja. 

Cinnabaris. 

A cid phosphoric. 
Sulphur. 

Pulsatilla. • 



As arum. 
Ignatia. 

Mezereum. 

A cid phosphoric. 

Mezer., Sulphur. 

Nux vomica. 

Ignatia. 

Spongia, Calc. 

Mercurius. 

Pulsatilla. 

Natr. murias. 

Cinnab. 

Acid nitric. 

Thuja. 

Arsenicum. 

Mercurius. 

Sabina. 

Caps., Acid phos. 

Helleb. niger. 



Cannab., Mercurius. 

Cannabis. 

Rhus tox. 

Arsenicum. 



BALANORRHCEA. 



57 



Spots, red ..... Thuja. 

bright red .... Cannabis. 

itching ..... Arnica. 
petechial (like flea-bites) . . Bryonia. 

brown, and painful (size of lentils) . Acid nitricum. 
Stitches, dull, tormenting . . . Sulphur. 

stinging and itching . . . Thuja. 

fine, through the glans . . Arsenicum. 

tearing and painful, at the fore part 
of the glans, drawing through the 
penis back into the anus, and ex- 
tending sometimes to the groin 
Tickling, with discharge of colorless mucus . 
fleeting, and itching . 
sensation between the prepuce and 
glans .... 

in the fore part, like a flea-bite 
Twitching between the prepuce and glans when 

walking . . 

Vesicles, small, in the orifice of the urethra, or 
on the inner surface and margins 
of the glans, which break and form 
round ulcers, like chancres 
on the front and side of the glans, 
which ulcerate and extend on all 
sides, sinking deep in its substance ; 
or small vesicles, which break, but 
heal rapidly 



Mercurius. 
Pulsatilla. 
Colocynth. 

Thuja. 
Belladonna. 

Cinchona. 



. Acid nitricum. 



Mercurius. 



SYMPTOMS OF THE PREPUCE. 



Burning, continuous, in entire prepuce and 
glans .... 

with vesicles appearing on the inner 
surface .... 
and corrosive prickling in the exter- 
nal parts .... 
itching, and prickling at the edge . 
Coldness, icy, of both prepuce and glans 
Itching relieved by rubbing, but soon return- 
ing . 
with moist spots on the inner surface . 
voluptuous . 

on and within the prepuce . 
painful, on the inner surface . 
disagreeable, on the right side and edge 



Cannabis. 

Mercurius. 

Cannabis. 

Bryonia. 

Sulphur. 

Aconitum. 

Acid nitricum. 

Euphrasia. 

Mercurius. 

Cannabis. 

Cannabis. 



58 BALANORRHCEA. 

Itching under the prepuce and at the frsenum . Cannabis, 
with swelling and redness, and also of 

the scrotum . . . Rhus tox. 

and biting on the inner surface, espe- 
cially towards the evening . . Nux vomica. 
at the inner and upper part . . Pulsatilla. 
Prickling and itching under the prepuce . Pulsatilla. 
whilst sitting or lying . . Pulsatilla. 
on the inner half . . . Rhus tox. 
itching at the edge . . . Chamomilla. 
frsenum . . Mercurius. 
Redness, the entire surface is dark red, hot, 

and inflamed . . . Cannabis. 

with burning pains . . . Mercurius. 

with thickening . . . Sulphur. 

itching and swelling of both scrotum 

and prepuce . . . Rhus tox. 

and painful sensibility of the inner 

surface .... Mercurius. 

and swelling at its junction with the 

glans .... Rhus tox. 

of both prepuce and fraenum . Sabin., 

of the right and lower side . . Cann., Cham., Cin- 

chona, Verat. 
Soreness of the edges, especially towards even- 
ing ..... Nux vomica. 



and ulcerative pains, 
the edges 



with itching at 



Stitches 



Ignatia. 



as from distention at the extremity . Ignatia. 

. Manganes. 
side . . Thuja. 



sensitive, in the inner i 

in the extremity . . . Cocculus. 

short . . . . . Acid nitric. 

stinging and burning on the external 

surface .... Cannabis 

when retracted . . . Hepar sulph. 

in the region of the fraenum . . Hepar sulph. 

Tickling . .... Thuja, Calc. 

itching, and biting, alternating with 

transient stinging at the anus . Thuja. 

itching, and biting at the back of the 

glans and frsenum . . . Acid phos., Merc. 

Rending pains on the left side and in the left 

testicle when in bed .... Cinchona. 
Vesicles, which become moist and itch . Acid phosphoric. 

when handled Acid phosphoric. 



GONORRHffiAL ACCESSORY AFFECTIONS. 

SOME accessory affections in direct relation with the 
gonorrheal discharge may accompany it as well as 
Balanorrhcea : they are either caused by the disease or 
induced by some accidental circumstance. The most 
frequent are, painful erections, satyriasis and priapism, 
chordee, haemorrhage from the urethra, inflammation of 
Cowper's glands, prostatitis, dysuria. 

ERECTIONS are present in almost every case of gon- 
orrhoea, are extremely painful, and always aggravate the 
inflammatory condition. The- pain is always more severe 
in the first instance than in those who have been several 
times affected with the disease. 

Prophylactic Treatment. — Absolute avoidance of 
all lascivious and moral excitement, abstinence from 
meat, eggs, or cheese, eating little or no supper, voiding 
the urine frequently, even at night, will frequently pre- 
vent or greatly ameliorate this distressing affection. 

Treatment. — The best remedies are Cantharis and 
Capsicum, although due regard must be had to the 
totality of the symptoms, for which reference should be 
made to the symptomatic indications for gonorrhoea. 

Capsicum is more especially indicated when there is 

violent erection constantly recurring through the day, 

without amorous thoughts, and only relieved by the use 

of cold water. 

Cantharis is more useful in very painful erections. 

with discharge of blood and pus, with or without great 

sexual desire, 

59 



60 GONORRHEAL ACCESSORY AFFECTIONS. 

SATYRIASIS AND PRIAPISM. — The first dis- 
ease, which is generally preceded by more or less sexual 
excitement, consists of an insatiable desire for con- 
nection, attended with permanent erection; lascivious 
images are constantly present to the imagination, even 
in sleep ; there is acute fever with glistening eyes, in- 
tense thirst, and foaming at the mouth ; raving lascivious 
madness supervenes, and if the disease is not checked, 
the organs become inflamed, gangrene rapidly sets in, 
and death ensues. Priapism is a much less severe form 
than the preceding, and frequently occurs during the 
course of gonorrhoea. 

Treatment. — In addition to mental treatment, the 
use of cold baths, cooling, drinks, total abstinence from 
animal food, and sleeping at night on a hard mattress, are 
necessary. 

The following indications for the^most important 
medicines in these complaints are here given, merely pre- 
mising, that due regard must be paid to the totality of 
the symptoms in each particular case. 

Cantharis. Frantic sexual desire, with priapism and 
excessive pain. 

Digitalis. Sexual excitement, with frequent and pain- 
ful erections night and day. 

Moschus. Violent sexual desire ; also with nausea 
and vomiting after an embrace. 

CHORDEE. — Sometimes the penis assumes a curved 
form, from violent inflammation and consequent exuda- 
tion into its cellular tissue ; the curvature is almost 
always downwards, but occasionally in a lateral direc- 
tion, with a rending sensation in the swollen part, 



GONORRHEAL ACCESSORY AFFECTIONS. 61 

especially in the frsanum. If not subdued, it may 
terminate in chronic disorganization, thickening, or 
induration. Should these latter supervene, a cure can 
no longer be expected, chordee remains a normal condi- 
tion of the parts, connection becomes more or less pain- 
ful, and sometimes even impossible. 

lodium. The external employment of this remedy, 
diluted with spirit to the color of sherry wine, will very 
frequently remove the affection in a clay or two, par- 
ticularly if the patient is of a scrofulous diathesis. The 
penis is to be painted with the above by means of a 
camel-hair brush twice a day. 

Capsicum is required w T hen chordee is associated with 
thick, purulent, yellow discharge, with excessive sensi- 
bility of the parts. 

Cantharis is to be preferred when, with yellow dis- 
charge and excessive burning pain, there is great and 
painful difficulty in making water, often followed by dis- 
charge of blood. 

Pulsatilla is requisite in chordee arising from sup- 
pressed gonorrhoea, or in case of venous congestion of 
the penis. 

[Lupulin, freely given at night, has been found effec- 
tual in some extreme cases.] 

H/EMORRHAGE FROM THE URETHRA. — This is 

of frequent occurrence when the inflammation is excessive, 
and is of no particular moment, if in slight quantity; 
but should the loss be great, the patient must be con- 
fined to the horizontal position, and cold water or ice 
must be applied to the penis. 
6 



62 GONORRHEAL ACCESSORY AFFECTIONS. 

Aconite, when there is strong inflammation, with 
hot, dry skin, and thirst, the penis being very hot and 
tense. 

Argenti nitras is very useful in discharge of blood and 
mucus, with painful tensive erections. 

Cantharis is indispensable in acute inflammation of the 
urethra, with extreme sensitiveness of the parts, dis- 
charge of blood and pus, and frequently bloody urine, 
with sharp pains in the back, and strangury. 

Millefolium. In discharges of blood and slime, with 
swelling of the penis. This medicine is often required in 
alternation with Argent, nit., or Canth. 

INFLAMMATION OF COWPER'S GLANDS, recog- 
nized by pain and swelling of the perinseum ; if not 
speedily arrested, inflammation and suppuration super- 
vene, frequently terminating in urinary fistula. 

Treatment. — In the inflammatory stage, Aconitum, 
Cinnabaris, and Mercurius corrosivus, are principally 
required ; in the suppurative stage, Hepar sulphuris, 
Silicea, and Thuja. 

Aconitum ; Mercurius corr. These two remedies 
should be given directly the premonitory symptoms 
appear, in alternate doses of five drops, each, every two 
hours. 

Cinnabaris is preferable to Merc. corr. if the patient 
is of a scrofulous or unhealthy constitution. 

Hepar sulph. When suppuration threatens, attended 
with throbbing in the perinaeum, and the Mercurius hav- 
ing proved ineffective, Hepar must be immediately re- 
sorted to. 

Silicea is preferable to Hepar when the abscess has 



GONORRHEAL ACCESSORY AFFECTIONS. 63 

broken, and the discharge is either clear and gelatinous, 
or thick and discolored. 

PROSTATITIS. — The prostate gland is conglomerate, 
of the size of a walnut, situated at the neck of the blad- 
der, and secreting a milky or colorless fluid, which serves 
to promote the emission of the semen during copulation. 
When this gland becomes inflamed, there is a sensation 
of heat and pressure in the perinaeum, towards the neck 
of the bladder and the rectum, with a sensation as if 
some foreign body were lodged there ; there is constant 
and painful urging to pass water, or stool, which in- 
creases with every attempt to satisfy the inclination, 
and is either fruitless or followed by a very scanty dis- 
charge. Suppuration generally ensues, if the disease be 
not checked by appropriate treatment, the pus being dis- 
charged either through the urethra, or through fistulous 
openings in the perinaeum. 

Treatment. — In acute cases, the principal remedies 
are Aeon., Bell, Bryon., Cann., Here, corros., Phosph., 
and Thuja. In chronic cases, Pulsatilla and Thuja. 

Aconite is required at the commencement, when there 
is hot, dry skin, full, bounding pulse, thirst, great rest- 
lessness, with burning and tenesmus at the neck of the 
bladder, with painful, anxious urging to urinate, the 
urine being very dark, acrid, and frequently depositing 
a red sediment. 

Cannabis is to be preferred when the urine is mixed 
with thready mucus or filaments, as if pus were present, 
with darting stitches at the posterior part of the urethra 
when standing ; and aching pain, with great desire to 
urinate. 



64 GONORRHEAL ACCESSORY AFFECTIONS. 

Mercurius, when the gland has become indurated, the 
feeling of pressure great, with heat and heavy aching 
in the perinaeum, and discharge of urine with white fila- 
ments and flocks, the sediment being white and thick. 

Pulsatilla is extremely useful in this complaint, par- 
ticularly in fair-complexioned persons, more particularly 
when there is great heat and pressure in the perinseum, 
accompanied with frequent erections and loss of pros- 
tatic fluid, constrictive pain extending to the bladder, 
with pressure as from a stone, and frequent and almost 
ineffectual urging to urinate. 

Thuja, when the symptoms are similar, the urine being 
bloody or depositing a brick-dust sediment. 

Phosphorus; Hep. sulph. ", Silicea. These remedies 
are required when suppuration is imminent, particularly 
when the patient is in ill health. 



CHRONIC INFLAMMATION OF THE PROSTATE 
GLAND, is generally the result of a neglected or ill-treated 
case of the acute form. The patients first complain of 
painful pressure in the perinaeum, only felt at first during 
an emission of urine or semen, but afterwards becoming 
continuous, and latterly increasing to a burning, extend- 
ing to the glans, testicles, and thighs ; an albuminous, 
colorless, rqpy fluid flows from the urethra, sometimes 
closing its orifice ; this fluid is more copiously secreted 
after an emission of semen, urine, or after stool, and is 
particularly aggravated by costiveness, excesses in drink- 
ing, or physical exertion. The pain now increases, the 
urging to urinate more violent, and the urine is expelled 
by fits and starts, the stream being sometimes divided, 



GONORRHOEAE. ACCESSORY AFFECTIONS. 65 

and mixed with mucous flocks, and a little urine, often 
of a dark color and ammoniacal odor, remains constantly 
behind in the bladder, causing an increased irritation of 
that organ. The existence of suppuration may be in- 
ferred from a constant desire to urinate, pain during 
micturition, and the presence of tenacious mucus or pus 
in the urine. In the perineal region the patient expe- 
riences a dull throbbing pain, with frequent chills, feb- 
rile symptoms, and even delirium. Whilst the suppu- 
rative process is going on, the abscess generally opens 
into the urethra, and its contents may be sometimes re- 
moved by means of the catheter. It may also be dis- 
charged into the bladder or rectum ; but, in whatever 
direction the abscess may break, the morbid symptoms 
subside, and recovery soon takes place. 

Arsenicum may be resorted to if the patient is much 
debilitated by the disease, particularly if it threatens to 
assume a malignant form, foul ichor being discharged 
from the urethra, with fetid colliquative diarrhoea and 
foul urine. 

Kali iodidum has been lately reported as an important 
remedy in suppuration of the prostate, particularly in 
scrofulous subjects, with fair complexion and bloated 
appearance. - 

lodium may prove serviceable in induration, or subse- 
quent atrophy of the gland. 

Mercurius may be required when the urine contains 
threads of mucus, or deposits a chalk-like purulent sedi- 
ment, and a heavy, aching pain is experienced in the 
perinaeal region. 

Silicea is useful in chronic suppuration of the gland, 
with heat and soreness, urging to urinate, and discharge 
6* 



66 GONORRHCEAL ACCESSORY AFFECTIONS. 

of fetid, discolored pus with the urine, the bowels being 
very costive. 

The following medicines may also be consulted: Acid, 
nitric, Argenti nitr., Aurum, Cannabis, Capsicum, Co- 
nium, Lycopodium, Nux vomica, Pulsatilla, Rhododen- 
dron, Spongia, Sulphur, Thuja, and Uva ursi. Vide 
Characteristic Effects. 

[For acute and chronic inflammation, hypertrophy, and 
tumors of the prostate gland, the following remedies are 
mentioned by Dr. Lippe.* (The indications which he 
suggests may be more readily found in Raue's Pathology 
and Therapeutics, page 405.) Pulsatilla, Thuja, Digi- 
talis, Cyclamen, Selenium, Causticum, Lycopodium, Se~ 
cale c, Copaiba, Zinc, Agnus c, Alumina, Hepar, Apis, 
and Sulph. acid. To these may be added Tussilago p., 
recommended by Rosenberg and Jahr.] -t 

PRURITUS GLANDIS; Itching of the Glans. — This 

complaint frequently occurs without any apparent reason, 
although it often accompanies the gonorrheal discharge. 
The patients complain of an intolerable itching of the 
glans, which induces such violent scratching that excori- 
ations of the parts are very frequently produced. This 
itching may likewise affect the genital parts of females 
suffering from leucorrhcea, or during and after the menses 
in perfectly healthy women. 

The principal remedies are, Sulphur, Calc, Caust., 
Antimonium crud., Arsenic. The particular indications 
which should lead to the selection of each respectively 

* Am. Horn. Review, Vol. III. p. 150. This article will well 
repay a careful study by all who have cases of this kind to treat. 



GONORRHEAL ACCESSORY AFFECTIONS. 67 

may be gathered from the article on Characteristic 
Effects. 

HERPES PRiCPUTIALIS ; Eczema Praeputialis. — 

This troublesome vesicular eruption, sometimes mistaken 
for incipient chancre, may affect both sexes, either with or 
without a syphilitic taint. In the male, the vesicles, of 
the size of a pin's head when fully developed, are seated 
on the prepuce and glans ; in the female, on the labia 
majora and minora. The patients are not aware of the 
disease until their attention is directed to it by the itch- 
ing of the red and swollen parts. The vesicles are 
generally clustered together, and sometimes coalesce. 

Treatment. — The most useful remedies are Acid, 
phos.y Petroleum, Thuja, and Veratrum ; \_Merc. corr.'] 
Vide Characteristic Effects. 

PHIMOSIS. — This is caused by the infiltration of 
fluid into the cellular tissue of the prepuce, forming a 
large, long, dark, reddish-brown, bulbous swelling at 
the extremity of the penis, its borders being enlarged, 
cracked, and so narrow that but a small portion of the 
secreted pus can make its escape, and rendering the 
retraction of the prepuce behind the glans impossible, 
the remainder collecting underneath, forming a fluctuat- 
ing swelling. Persons with a long and narrow prepuce are 
the most subject to it, and balanorrhcea is always present. 

Treatment. — If the remedies are selected with care, 
the disease is generally easily subdued, and it is only in 
very severe cases, and when gangrene threatens, that 
the knife becomes necessary. Should the apparently 
appropriate remedies be of no avail, slight incisions in 



68 GONORRHEAL ACCESSORY AFFECTIONS. 

the prepuce will allow much of the fluid to escape, and 
pave the way to speedy relief. 

Merc, corros. is indicated when there is violent swell- 
ing of the prepuce, like a bladder, with burning, biting 
redness, and painful sensibility, with cracks and fissures 
on the inner surface. 

Rhus tox. is required when there is puffy swelling of 
both prepuce and glans, with itching and moist eruption 
on the scrotum. 

Cannabis should be given when there is dark-red, hot, 
and inflamed prepuce, which is swollen in connection 
with the fraenum. 

Cinnabaris is useful when there is swelling, redness, 
and soreness of the prepuce, with itching pain. 

Sulphur. When the patient is of a scrofulous habit, 
and no relief is afforded by other remedies, although 
apparently well indicated, a few doses ~6f Sulphur will 
frequently produce striking amendment. 

Note. — In this, as in other affections complicated 
with another disease, a reference to the indications for 
both will materially aid in the selecting the appropriate 
medicine. 

PARAPHIMOSIS.— Retraction of the prepuce behind 
the glans is termed paraphimosis, and is much more 
dangerous, as, should the constriction be not speedily 
removed, strangulation of the part ensues, and the whole 
penis is likely to be destroyed by gangrene. In these 
severe cases there is no remedy but the knife. The 
remedies are the same as used for phimosis. 

Colocynth has lately been employed with success in 
obstinate cases, and has been recommended in prefer- 



GONORRHEAL ACCESSORY AFFECTIONS. 69 

ence to all other medicines for effecting or facilitating 
reduction.* 

CYSTITIS; Inflammation of the Bladder. — This is 

characterized by burning pain in the region of the blad- 
der, with tension, heat, pain on pressure, and external 
tumefaction. The pain and anguish are increased by 
the violent urging to urinate, which is often ineffectual, 
or the urine can only be discharged by drops ; great 
thirst and fever are always present, sleep vanishes, and 
the patient rapidly emaciates. The disease in question 
(cystitis from acute or suppressed gonorrhoea) generally 
involves the prostate gland and the surrounding parts, 
and in very severe cases extends even to the kidneys. 

Treatment. — Absolute rest, and a diet of linseed-tea, 
barley-water, or some mucilaginous drink, are the chief 
accessories in bringing this complaint to a successful 
issue. Animal food, spices, or spirits, are positive poi- 
sons in this disease. It is also advisable to dissolve the 
medicines in a large quantity of water, as it serves to 
dilute the urine, which is always very acrid. Distilled 
or boiled and filtered rain-water are preferable for drink- 
ing to ordinary pump-water. 

Aconitum is ever requisite in the initiatory treatment 
of this disease, if there is hot, dry skin, and quick 
hard pulse. 

Cantharis is indispensable in this complaint, and should 
be given singly or in alternation with Aconite. It can 
even precede it, should the accompanying fever be only 
moderate. 

Hyoscyamus is useful when urination is difficult, and 
* Laurie's "Elements of the Practice of Physic," p. 495. 



70 GONORRHEAL ACCESSORY AFFECTIONS. 

the inflammation not far advanced, or when these symp- 
toms appear to be more spasmodic than inflammatory. 

Digitalis is useful when, in addition to the suppression 
of urine, constrictive pains are felt in the bladder. 

Acid phosph. can be given for paleness of the face, 
heat, and intense thirst, milky urine, with cramp-like 
constriction of the bladder. 

Arsenicum cannot be dispensed with, when intense 
thirst, distressing anxiety and restlessness, great fear of 
death, and rapid sinking of the vital powers prevail. 

Sulphur, Silicea, will frequently be required at the 
termination of the disease, should it threaten to end in 
suppuration or perforation. The selection must be made 
in conformity with the detailed indications in the Char- 
acteristic Effects. 

CHRONIC INFLAMMATION OF TH£ BLADDER.— 

This complaint is accompanied by a very irritable state of 
the organ, and profuse secretion of mucus, which passes 
off with the urine. Hence it is often termed Catarrh of 
the Bladder. 

The principal remedies are, Pulsatilla, Dulcamara, 
Sulphur, Hepar sulph., Mercurius, Phosphorus, Can- 
nobis, Kali carb. 

The selection to be made in conformity with the char- 
acteristic action of each. 

Vide Catarrh of the Bladder. 

EPIDIDYMITIS.— The epididymis is a small, oblon- 
gated, grayish body, about the size of a goose-quill, rolled 
on the superior part of each testicle, and formed by the 
windings of all the seminal ducts united into one canal. 



GONORRHEAL ACCESSORY AFFECTIONS. 71 

It is liable to be affected with acute inflammation, in 
severe cases of gonorrhoea, when all the surrounding 
parts are implicated. 

Treatment. — This disease running a rapid course, the 
appropriate remedies must be sought for immediately on 
its invasion. At the same time, all sexual excitement 
must be avoided, and a suspensory bandage worn for 
some weeks, even after all disappearance of the gonor- 
rhoea. There is always some fever when the disease is 
acute, particularly when the spermatic cord is implicated, 
and the parts are so sensitive that the least pressure will 
frequently induce fainting. 

It will be necessary to compare the indications here 
presented with those for gonorrhoea, as we cannot hope 
to allay the inflammation in the epididymis whilst the 
gonorrhoea! affection is still unchecked. 

Argent, nit. Contusive pains, with enlargement and 
hardness of the right testicle. 

Arsenicum. Cramp-like, cutting colic, darting through 
the abdominal ring and perinaeum, considerable swelling 
of the testicles, and phenomena resembling those of in- 
carcerated hernia. 

Aurum. Swelling of the testicles, with pressive pain 
on contact, and aching tensive pains in the right testicle, 
which is swollen in the lower part. 

Belladonna. Repeated tearing in the left spermatic 
cord, from below upwards, in the evening, or when 
falling asleep ; lancinations in the testicles, which are 
drawn up. 

Cannabis. Tensive pains in the spermatic cord, and 
contraction of the scrotum; sensations of pulling or 
pressure in the testicles, 



72 GONORRHEAL ACCESSORY AFFECTIONS. 

Capsicum. Drawing pains in the spermatic cord, and 
cramp-like pains in the testicles, during and sometimes 
after urination. 

Cinchona. Painful swelling of the spermatic cord and 
testicle, but especially of the epididymis ; tearing pains 
in the left testicle and the left side of the prepuce ; 
cramp-like, contractive pains in the testicles and urethra, 
especially in the evening. 

Clematis. Painful inflammation, and swelling of 
both testicles ; ascending pains in the testicles and sper- 
matic cord ; induration of the testicles. 

Cocculus. Stitching pains in one or the other tes- 
ticle, and violent pains, as if bruised, or drawing pains, 
especially on pressure or even contact. 

Ignatia. Strangling sensation and aching sensation 
in the testicles, especially after lying down at night. 

Mercurius. Sensation of coldness in the testicles ; or 
they are hard and swollen, with shining redness of the 
scrotum, with dragging pains, itching, tingling, and 
shooting, both in the testicles and spermatic cord. 

Acid nitric. Inflammatory swelling and relaxation of 
the testicles, with painful swelling of the spermatic cord. 

Acid phosph. Gnawing pains in the testicles, which 
are swollen, whilst the spermatic cord is enlarged, hard, 
and tightened. 

Pulsatilla. Inflammatory swelling of the testicles and 
spermatic cord, with pressive and tensive pains extend- 
ing into the abdomen; the right testicle is drawn up 
and swollen, whereas the left is hanging down relaxed ; 
or the testicles hang down very loosely, with drawing 
tensive pains passing out of the abdomen through the 
spermatic cord. 

Rhododendron. Distressing pains in the epididymis, 



GONORRHEAL accessory affections. 73 

worse when touched, whilst the testicles are swollen and 
retracted. It is also useful when they are indurated. 

Spongia. Squeezing, strangulating pain in the tes- 
ticles, or aching swelling, with dull, darting stitches, 
affecting also the spermatic cord. 

Staphysagria. Violent drawing, burning stitches from 
the right abdominal ring, apparently in the spermatic 
cord, as far as the right testicle ; or drawing with pres- 
sure in the right testicle, as if it were violently com- 
pressed, and aching pains in the outside of the left tes- 
ticle when walking, increased by touching the part. 

Sulphur. Testicles relaxed and hanging down, with 
pressure a\id tension in the spermatic cord; vibrating 
sensation in the testicles and neighboring parts. It is 
also useful when induration has set in. 

Teucrium. Descent of the right spermatic cord 
towards the abdominal ring, with great sensation of 
pressure ; crampy sensation deep in the abdomen, which 
extends to the testicles, as if they had been violently 
squeezed ; the integuments of the left testicle feel sore 
when touched. 

Thuja. Aching pain in the testicles as if crushed, 
aggravated by walking, with repeated sharp stitches, 
extending to the spermatic cord. 

EPIDIDYMITIS. — SYMPTOMATIC INDICATIONS. 

Aching in the testicles .... Ignat., Scilla. 

in both testicles .... Aconitum* 
Constrictive pain in the left testicle . . Argent, nitras. 

in the right testicle . . Digit., Spongia. 

very violent in both . . Cocculus. 

Contractive pain .... Nux vom., Merc. 

spasmodic pain . . . Cinchona. 

Drawing and violent continued pain in the left 

testicle ..... Colocynth. 

7 



74 GONORRHEAL ACCESSORY AFFECTIONS. 

Painful sensibility . . . . Acid nit. , Rhod. 

Pressive pain in both testicles . . . Ac.phosph.,Canth. 9 

Thuja. 
in the left testicle . . Staphysagria. 

Rending pain ..... Pulsatilla. 
spasmodic pains, with itching . Mercurius. 

in the left testicle . . . Ac. phosphoric. 

Strangling pain ..... Ignatia. 
Swelling of the epididymis, which is painful to 

touch .... Cinchona. 

violent, after a previous diminution . Baryta carb. 



[Orchitis; Swelling of the Testicles and Scro- 
tum. — Swelling of the testicles forms one of the most 
painful complications of gonorrhoea. It may be confined 
to the convolutions of the epididymis, {epididymitis;) or 
involve also the surrounding cellular tissue of the scro- 
tum. It results from exposure to the wet and cold; from 
being too much on the feet ; and from suppression of the 
gonorrhoeal discharge by injections. In the latter case, 
the symptoms are well covered by Pulsatilla, which 
will often relieve the swelling by restoring the discharge. 
In some cases, Mercurius may be needed ; in others, 
Aurum, or Clematis. 

In phlegmonous inflammation of the testicles, Aconite 
is highly recommended by Hempel, who has cured such 
cases with the thirtieth potency. If the inflammation 
is extensive, involving the spermatic cord, and is, more- 
over, attended with cerebral symptoms, torpor, slight 
delirium, Belladonna, says Dr. Hempel, will be found 
indispensable. Rhus will be required, if the swelling 
of the scrotum (right side) have been induced by ex- 
posure to wet, or aggravated by too much standing. A 
case of this kind occurred to us some years ago of a 
tailor, who, from being constantly on his feet, cutting 



GONORRHEAL ACCESSORY AFFECTIONS. 75 

out garments, got one testicle and side of the scrotum 
larger than his two fists, without abatement of the dis- 
charge. 

Induration of the Testicle, often of years' stand- 
ing, the result of mismanaged gonorrhoea, requires Au- 
rum or Clematis, according to the prevailing conditions; 
Aurum especially, if the patient has been mercurialized. 
In these old cases, seldom repeated doses of the thirtieth 
or some still higher potency have been found efficacious. 
Conium should be considered, if the induration seems 
to have been (even partially) consequent upon a local 
contusion.] 

STRICTURE OF THE URETHRA. — Diminution of 
the transverse diameter of the canal is one of the most fre- 
quent disorganizations resulting from gonorrhoea. There 
are several varieties of the complaint, some of w^hich 
are much more intractable than the rest. Inflamma- 
tory strictures develop themselves during the course 
of, or after, acute gonorrhoea, and are generally cured in 
two or three weeks ; membranous strictures arise 
from the formation of folds or valves in the mucous 
membrane ; fleshy strictures, from partial swelling 
of the lining membrane; fibrous or cartilaginous 
strictures are caused by cicatrized wounds or ulcers; 
varicose strictures, by engorgement of the blood- 
vessels ; and by mixed strictures is understood a spas- 
modic condition, with an alteration of the tissues. 
Spasmodic strictures affect only the membranous por- 
tion of the urethra, and may involve the whole length 
of the canal, so as to form a very narrow tube ; whilst 
organic strictures are generally deeply seated, usually 



76 GONORRHEAL ACCESSORY AFFECTIONS. 

under the symphysis pubis, at the junction of the 
spongy with the membranous portion. The following 
symptoms indicate the invasion of the disease : Soon 
after the termination of an improperly treated gonor- 
rhoea, the orifice of the urethra is found in the morning 
closed with mucus, leaving dirty-yellow stains on the 
linen. This discharge is not infectious, but it indicates 
the commencement of stricture : the stream of urine be- 
comes thinner, slower, and falls more perpendicularly ; 
at first it is flat, but becomes twisted or divided into 
several branches, and at last the urine passes off very 
slowly, and in drops. The constant urging to urinate is 
particularly troublesome at night, and the difficulty of 
passing water is equally annoying. Great care must be 
taken not to force the discharge of urine, as serious 
consequences, such as hernia, or prolapsus of the rectum, 
may ultimately ensue. Patients often endeavor to avoid 
the necessity of frequent urination, and therefore abstain 
from drinking to a great extent: this only aggravates 
the evil, as the urine, being more concentrated, is con- 
sequently more corrosive and irritating than it was 
before, the urging is more frequent and excessively 
painful, the urine can only be discharged in drops, and 
strangury frequently is the result. The urine also con- 
tains more azote in its composition, is mixed with pus 
and mucus, depositing a dirty-white, cloudy precipitate 
on standing, and exhales a pungent, disagreeable, am- 
moniacal odor. Partial or complete incontinence may 
set in, in the course of the disease, causing an enlarge- 
ment of the urethra, extending to the neck of the blad- 
der. If partial, a small quantity of urine is involun- 
tarily discharged drop by drop after every emission, 



GONORRHEAL ACCESSORY AFFECTIONS. 77 

the clothes get wet, and exhale a fetid odor in spite of 
the greatest cleanliness. In complete incontinence the 
inconvenience is very distressing, the urine passing off 
continually, and necessitates the use of a caoutchouc 
bag. The diagnosis of the various kinds of stricture 
and their mechanical management, should be confided, 
if possible, to an experienced surgeon, as no written de- 
scription would enable patients to distinguish their cases 
with certainty. 

Owing to the fact that a stricture always tends to 
increase even to the complete closure of the passage, the 
prognosis is generally doubtful ; the nearer it is to the 
outer portion of the urethra, the more recent and dilat- 
able, and the less extensive and contracted, the sooner 
it is removed. Complications and constitutional de- 
rangements increase the difficulty, and often render it 
incurable. 

Treatment. — For spasmodic stricture, and the lighter 
forms of swelling in the mucous membrane of the ure- 
thra, the annexed list of medicines w T ill be worthy of 
study. Agaricus, Clematis, Conium, Cantharis, Iodium, 
Kali iod., Mercurius, Acid nitric, Silicea, Stramonium, 
Sulphur. 

The principal remedies for spasmodic strictures are : 

Aconite: required when there is inflammatory fever; 
constant and distressing urging to urinate, with inability 
to pass any urine. 

Cantharis. Similar symptoms, with discharge of a 
few drops of blood instead of urine. 

Belladonna is requisite when there is frequent urging, 
the urine being natural, or gold-colored. 



78 GONORRHEAL ACCESSORY AFFECTIONS. 

Camphora, when strangury is present, the urine pass- 
ing in a thin stream, and is very acrid. 

Dose. — Two drops of the concentrated tincture, on a lump of 
sugar, every twenty minutes till relieved. 

Digitalis is very useful when there is continual desire 
to urinate, but emitting only a few drops each time, with 
sensation as if the bladder were too full; or when there 
is pressing and burning in the middle of the urethra, as 
if it were too narrow. 

Argenti nitras is requisite when there is burning urine, 
and pain in the urethra, as if swollen and closed. 

Nux Vomica, for painful, ineffectual desire to urinate. 

Opium. Spontaneous interruption of the stream when 
urinating, or sometimes complete suppression for the time 
being. 

Thuja. Difficult micturition; the stream is arrested 
half a dozen times, before the urine is entirely voided. 

In organic strictures, however, a surgical operation 
is unavoidable ; the use of bougies is the first step to be 
taken, commencing with a very small-sized one, and pro- 
portioned to the size of the stream. Having well oiled 
it, we introduce it carefully into the urethra, and pass it 
gradually towards the stricture, turning it irregularly in 
various directions, should the course of the stricture 
prove to be irregular ; this is very frequently a delicate 
and troublesome operation, the bougie sometimes being 
arrested by a fold of the mucous membrane, or one of 
the mucous follicles, situated along the lower wall of 
the urethra, or (in old offenders) by false passages. In 
such cases the bougie is to be drawn back, and the penis 



GONORRHEAL ACCESSORY AFFECTIONS. 79 

pulled forward for the purpose of removing the obstacle, 
which sometimes interposes such difficulties that an 
hour or so is frequently required to accomplish the ob- 
ject. It is therefore necessary to observe, that great 
care, caution, and patience be exercised, and that no 
rash forcing of the instrument be resorted to, as serious 
mischief would inevitably follow. The bougie may be 
introduced once or twice a day, and may be gradually 
increased in size, always taking care to insert the 
smaller-sized one first, and allow it to remain a few 
minutes, before employing the larger one. As to the 
length of time it may be allowed to remain, that depends 
upon the feelings of the patient, some bearing it much 
better than others. The good effects of the bougie are 
generally quickly manifested, the urging to urinate 
being much lessened, and the stream increasing in size ; 
at first the mucous discharge is increased, but as the 
stricture dilates, it decreases, and finally entirely ceases ; 
the patient now, with appropriate treatment and the use 
of the instrument, rapidly progresses, the symptoms 
yield one by one, and in general perfect recovery takes 
place. 

As the introduction of the bougie often causes great 
faintness and trembling, a dose or two of the Tincture 
of Aconite (1), five drops, in a wine-glass of water, at 
ten minutes' interval, will generally speedily remove the 
abnormal symptoms. 

In severe disorganizations, however, the cure is not so 
easily accomplished, and it is often requisite to leave the 
instrument in the passage for many days or weeks, with- 
drawing it every day to clean it, or to substitute one of 
a larger size. Should there be a valvular stricture, the 



80 GONORRHEAL ACCESSORY AFFECTIONS. 

knife is necessaiy to remove it, although cauterization is 
sometimes employed, which has the merit of obviating 
the severe haemorrhage which often follows the use of 
the bistoury, but not of preventing the contraction of 
the cicatrix, which calls for the continual employment 
of the bougie. 

GONORRHCEAL OPHTHALMIA. — This extremely 
severe disease requires the promptest attention, disor- 
ganization and bursting of the eye not unfrequently 
taking place within even twenty-four hours from its first 
invasion. It therefore behoves patients troubled with gon- 
orrhoea to take especial care that none of the discharge 
be jerked into the eye through carelessness, and that 
towels or sponges used for washing the penis be kept 
entirely separate from everything else ; also that they 
be either destroyed when done with* {always advisable 
with sponges), or thoroughly cleansed with a strong solu- 
tion of potash afterwards, before using. These precau- 
tions cannot be too strictly attended to, as many inno- 
cent persons have entirely lost their sight and been 
disfigured for life, by the carelessness of patients troubled 
with gonorrhoeal discharge. In fact, inflammation of 
the eyes, occurring during this complaint, should be 
always regarded as malignant, and treated accordingly. 

There are three distinct stages in this complaint: The 
first generally sets in with a violent burning itching, 
especially at the edges of the eyelids and the corners of 
the eyes, accompanied with a profuse flow of acrid tears, 
and considerable intolerance of light ; the conjunctiva is 
uniformly injected, and the upper lid is much swollen, 
the tears becoming turbid towards the end of this stage : 



GONORRHEAL ACCESSORY AFFECTIONS. 81 

there are also fever, dull heavy headache, coated tongue, 
and violent thirst. The second stage now commences 
by the conjunctiva becoming more swollen, the tears are 
mixed with yellowish- white pus, which speedily increases 
in quantity and thickness, gradually assuming a greenish 
tint, and inflaming and corroding the cheeks in flowing 
down. Sometimes the upper lid swells to the size of 
a hen's egg, the lower lid being always less swollen. 
The pains now become extremely acute and spread over 
the whole head, the conjunctiva more and more injected, 
forming a pad-shaped elevation round the cornea, cover- 
ing its margin, and ultimately projecting beyond the lids 
as a dark red mass (chymosis). The pus now pours 
down profusely, and in a few hours the cornea assumes 
a uniformly grayish or yellowish appearance. If these 
alarming symptoms are not speedily checked, the cornea 
ulcerates and in a few hours bursts, discharging the 
whole contents of the eye, which speedily collapses, and 
total and irrecoverable loss of vision, staphyloma, and 
other unsightly disorganizations, are the result. The 
pains now decrease, the discharge becomes less, more 
fluid, and less corrosive, the fever entirely ceases, but 
the disorganizations remain, and require a special treat- 
ment (generally surgical), according to their nature. 

Absolute rest, a darkened apartment, un stimulating 
diet, are indispensable to a favorable recovery. 
. Prophylactic Treatment. — No time should be lost, 
after the gonorrhceal discharge has entered the eyelids, 
in thoroughly syringing the eyes with warm water to 
dilute and remove the pus. 

In order, however, to prevent any ill effects arising, 
the alternate administration of Aconite, and Sulphur, 



82 GONORRHEAL ACCESSORY AFFECTIONS. 

five drops of the tincture in a wine-glassful of water 
every hour, is especially recommended. 

Treatment. — Aconite ; Sulphur. These two reme- 
dies, taken alternately, will generally serve to arrest the 
complaint if taken when the burning, irritation, and red- 
ness first make their appearance. 

Arsenicum is necessary when the redness of the eyes 
is very considerable, the tears being very profuse and 
acrid, with violent burning pains in the part. 

Argenti nitras is generally the sheet-anchor in this 
disease, and must be resorted to immediately if pus has 
already formed ; the redness, intolerance of light, pains 
in the head, and swelling of the eyelids, showing but too 
clearly the malignant nature of the complaint. 

In very severe cases, a lotion composed of one grain of 
crystallized Nitrate of silver in one ounce of distilled 
water, must be dropped into the eye -every hour. In 
many cases the internal use of Tincture of Aconite (1) 
in alternation will be very efficacious. 

Mercurius corrosivus is very effectual when the disease 
does not assume such a malignant form, but the redness, 
burning, and discharge of pus are still very great, or 
when symptoms of iritis (known by discoloration of the 
iris, irregular shape of the pupil, which often rapidly 
contracts and sometimes irrecoverably closes, the pres- 
ence of a radiated ring of blood-vessels around the 
cornea, and pain across the temples) make their ap- 
pearance. 



[VENEREAL RHEUMATISM. 

T^ HEUMATISM may arise in connection with gonor- 
-LV rhcea, or with syphilis, or with both occurring toge- 
ther. In cases of gonorrhoea, rheumatism may appear while 
the discharge still continues ; when it has been apparently 
but only partially and imperfectly cured, or when it has 
been suppressed by injections. In persons predisposed 
to rheumatism, it may make its appearance while the 
discharge still continues. Or if, soon after being cured of 
gonorrhoea, the patient goes in bathing while yet the 
water is quite cool, the original discharge may return and 
become more difficult of removal than before ; or an in- 
veterate gonorrheal rheumatism may be established. In 
cases of syphilis, the rheumatism seems to be developed 
principally as a consequence of excessive mercurializa- 
tion. 

The joints most frequently affected in venereal rheuma- 
tism, are those of the knee, the elbow, the wrist and the 
ankle. The pains are very severe; worse on motion, and 
usually much Avorse at night. In addition to the local 
inflammation, some general fever will often be developed. 
The irritable bladder, and incontinence of urine, which so 
often appear in connection with gonorrhoea, may result 
from this kind of rheumatism affecting the neck of the 
bladder. 

The several forms and complications of rheumatism 
with venereal affections, may thus be summed up : 

I. Rheumatism with present gonorrhoea. 

II. Rheumatism in imperfectly cured gonorrhoea. 



84 VENEREAL RHEUMATISM. 

III. Rheumatism in gonorrhoea suppressed by injec- 
tions ; (either of these forms may be again complicated by 
a mercurialized condition of the patient's system, whether 
acquired formerly or more recently.) 

IV. Rheumatism with Syphilis. 

Y. Rheumatism with Syphilis and Gonorrhoea. — 
These two latter forms will almost invariably be found 
complicated by a strongly mercurialized condition of the 
system ; while the gonorrhoea! discharge, suppressed by 
injections, may still further increase the difficulty, if it 
do not obscure the case. Each of these forms and com- 
plications I have seen, and treated successfully with 
Homoeopathic Medicines. 

Aconite. Often indispensable in the early treatment 
of venereal rheumatism ; especially when there are both 
local inflammation and considerable general fever. 

Rhus may be required when the rheumatism has been 
induced by exposure to the wet, as in bathing. 

Pulsatilla. Especially indicated where the discharge 
has been suppressed by injections. Wandering rheu- 
matic pains characterize this remedy in a remarkable 
manner. Other indications may be found in its well- 
known constitutional symptoms. 

Kalmia latifolia may be called for when Pulsatilla is 
indicated by the wandering pains, but fails on account 
of not being able to overcome the mercurial influence 
present in the system. 

Kalmia has been used with much benefit in the cure 
of syphilis ; the pains are most severe while moving, and 
disappear while lying. Frequent pains here and there in 
the limbs, continually changing from one place to another. 
Pains go from the upper to lower parts. The rheumatic 



VEXEREAL RHEUMATISM. 85 

pains are mostly in the upper arms and lower parts of 
the legs ; and are worse on going to sleep. Suitable for 
gonorrheal (and even syphilitic) rheumatism in mercu- 
rialized patients. 

Daphne indica. Articular rheumatism consequent upon 
suppressed gonorrhoea. Pains worse at night. Violent, 
crampy pains at night, (all night,) about the joints. 
Pains in the bones. Darting pains, like shocks, in vari- 
ous parts, frequently and suddenly wandering from one 
part to another. Remarkably adapted to gonorrheeal 
rheumatism occurring in mercurialized syphilitic persons. 

Kali iod. Most important in venereal rheumatism, — 
especially syphilitic, — where the patient has been mer- 
curialized. In recently mercurialized cases it may re- 
quire to be given in substantial or massive doses. 
Rosenberg prescribed one grain in six ounces of water, 
curing with this dose more rapidly than Lobethal with 
doses ten times as large.* The wonderful complemen- 
tary relation of Kali iod. to Mercury is such that, 
while by itself it can never cure a case of pure syphilis, 
it acts like a charm in those which have been modified 
by mercurial treatment, curing them rapidly and 
thoroughly. 

Phytolacca decandra. One of the most powerful, 
valuable, and least known of the indigenous plants of 
America. Of all the vegetable antidotes of mercury this 
is one of the most efficacious ; while it is both useful in 
rheumatism and said to be specific against syphilis. 
Hence it will be indicated in the rheumatic complica- 
tions of mercurio-syphilitic affections. In syphilitic 
rheumatism it may be considered almost a specific. 

* Jahr's Venereal Diseases, p. 423. 



86 VENEREAL RHEUMATISM. 

And the additional presence of a gonorrheal complication 
in such cases — particularly if they have been previously 
mercurialized — would by no means counterindicate this 
remedy ; provided, always, that the other symptoms cor- 
respond. Pains, neuralgic, (mostly on right side,) worse 
at night, after midnight ; increased by motion and by 
pressure ; rendered endurable only by energetic walking ; 
coming on in the hip, tibia and fibula, from 1 to 5 A. m.* 

Asafcetida must also be studied in this connection. 
With the thirtieth of this remedy I once cured a case of 
syphilitic rheumatism of the wrists and ankles of long 
standing, which had been the rounds of some half a 
dozen Allopathic physicians. The patient, who had 
taken Mercury, Kali tod., and Ferri iod. in all forms 
and in any quantity, was a barber, and his wrists were 
so stiff and lame that he could scarcely work at his 
trade. But in a few weeks a great improvement was 
effected, (by the Asa/. 30 ,) which continued till he was 
as well as could be expected. 

Sarsaparilla should be carefully studied. 

Thuja oc. combines all the elements of these compli- 
cated forms of disease, and will often be found indis- 
pensable, especially if condylomata or fig-warts appear.] 

* Bost. Horn. Quarterly, I. p. 436, 1849. 



TRUE SYPHILIS. 

CHANCRE. — We have now to treat of a disease less 
painful than the preceding affection, but infinitely 
more dangerous, on account of its tendency to progress 
(unless arrested) to a fatal termination, in contradistinc- 
tion to gonorrhoea, which often wears itself out without 
any treatment. 

The disease in question makes its appearance from 
three to six days after infection, in the form of a small 
red spot or vesicle, with inflammation of the part and 
itching. The centre of the spot rises rapidly, becomes 
whitish and transparent, a reddish and corrosive serum is 
discharged, and an ulcer is formed, its malignant nature 
being shown by its circular form. The ulceration ex- 
tends both laterally and into the substance of the penis, 
its margins become hard and cartilaginous, and the 
inner surface assumes a grayish or lardaceous appear- 
ance, which cannot be detached, the opening of the ul- 
cer being narrower than at its base. In man, the glans 
and prepuce are principally affected ; in women, the 
labia, clitoris, and orifice of the vagina. Chancres are 
distinguished according to their nature : — 1st, the super- 
ficial chancre ; 2d, the indurated chancre ; and 3d, the 
phagedenic, gangrenous, or sloughing chancre. 

The superficial ulcer has its margins, which are con- 
siderably elevated, sometimes spongy, but is not accom- 
panied with induration. The edges are never jagged, 
but always sharply circumscribed ; the sore looks clean, 
of a flesh-red color ; the discharge is thin, copious, and 



88 TRUE SYPHILIS. 

generally mixed with blood ; this form usually heals 
quickly. 

The indurated chancre has its edges more or less 
jagged, elevated, slightly painful, with a copper-colored 
circumference ; its base is indurated and lardaceous, the 
ichor adhering very firmly, which washing will not re- 
move. The discharge is of a light-yellow color, viscid, 
and glutinous, occasionally acrid and offensive, staining 
the linen ; this variety extends far more in depth than 
breadth. 

The phagedenic chancre develops itself principally in 
scrofulous individuals ; there is little induration, but its 
edges are thin, shaggy, or rolled up, of a brown or violet 
color, the secretion thin and fetid. The ulcer is usually 
covered with a gray layer of false membrane, beneath 
which the destruction of the tissues proceeds alarm- 
ingly, particularly when badly treated. It is very sub- 
ject to dangerous haemorrhage, and, in severe cases, 
becomes gangrenous. 

The sloughing chancre commences as a black spot, 
which extends, breaks, and discloses a corroded surface ; 
the ulcer now presents a dark blue or livid crimson mar- 
gin, is excessively painful, and if not quickly arrested, 
particularly when occurring under unfavorable circum- 
stances, sloughs rapidly, destroying the whole of the ex- 
ternal sexual organs, and even the neighboring parts. 

According to Rauff, chancres in the mouth are gen- 
erally secondary, being more superficial, and wanting 
the lardaceous appearance presented by those of the 
pharynx and palate. Those of the nose are still less 
frequent, and smaller than either of the others. 

The chancre may pass from the acute to the chronic 



TRUE SYPHILIS. 89 

form without ceasing to be primary, but when it loses 
its syphilitic character, venereal spots make their ap- 
pearance, with pimples on the forehead and chin, and 
around the mouth. 

\_Chancre is the name of the primary syphilitic ulcer; 
that is, of the first form of syphilis itself ; of the existence 
of which it usually affords the principal if not the only 
decisive evidence. 

I. Our author's distinction of Superficial and Indu- 
rated Chancre is itself both superficial and misleading. 
For every simple Hunterian chancre is first soft and 
superficial ; and acquires its indurated character usually 
in five or six days ; although in exceptional cases the 
induration may be developed in the first twenty-four 
hours. The characteristic of the regular, simple, Hun- 
terian Chancre, whether soft or indurated, is its " funnel- 
shaped, depressed form, with abruptly rising erected 
edges ; and the fact that the induration invariably appears 
after a short period." * Thus both the superficial and the 
indurated chancre of Berjeau belong to the former class, 
which Jahr, in common with other modern authors, de- 
scribes as the regular, simple, Hunterian Chancre. 
This generally locates itself on the fraenulum, corona 
glandis, or on the glans itself ; and is the mildest form 
of the terrible syphilitic disease. For this, Merc. sol. 
is usually the sufficient remedy. 

II. The Elevated Chancre forms Jahr's second class : 
" When first breaking out, it looks like a small whitish 
ulcer of the size of a small split pea to that of a dime. In 
eight or ten days, or even sooner, the edges of the ulcer, 

* Jahr, Yen. Dis. p. 95. 
8* 



90 TKUE SYPHILIS. 

together with its base, become raised, forming an elevated, 
projecting, whitish gray ulcer, of a spongy appearance. 
These ulcers generally are of an oval shape ; they secrete 
a purulent serum, are not very, or even at all painful ; 
neither the edges nor the base are indurated. 11 — Jahr. 
"The regular, simple Hunterian Chancre" — continues 
the same author — "usually forms a single isolated 
ulcer ; while the Elevated Chancre very frequently con- 
sists of several ulcers.' 7 

In this elevated form of chancre, (which however can- 
not be distinguished by the elevation alone from the 
simple chancre in the first few days,) the principal 
remedy, according to Jahr, is still Mercurius solubitis, of 
which (as in a simple chancre) he recommends one half 
a grain of the first centesimal trituration to be given 
morning and evening* This remedy, he says, will 
undoubtedly prove most specifically curative as long as 
the chancre still presents its ash-colored, lardy appear- 
ance, and will even surpass in curative power any other 
agent, in cases where the elevated ulcer has passed into 
the Hunterian form of chancre. 

Where the lardaceous period has been neglected, 
and new condylomatous growths appear, Cinnabar may 
be indicated ; or rather Nitric acid, which Jahr pro- 

*"I use Mercury in all Chancreous Ulcerations. If resembling the 
simple or Hunterian chancre, I employ Merc. sol. ; in the phagedenic 
form I prefer Merc, corros., until an improvement sets in, after 
which I continue the treatment with Merc. sol. Regarding the dose : 
I never give, in urgent cases, lower than the second trituration 
of Mercury, in one-half -grain doses, morning and night, giving 
only one dose every morning on the third or fourth day, and 
after this period, one dose every other day." — Jahr, Ven. Dis. 
p. 247. 



TRUE SYPHILIS. 91 

nounces superior to Cinnabar in all such cases. But if 
Merc. sol. is not sufficient in recent cases of elevated 
chancre, Cinnabar is preferable to Nit. acid. 

If the Elevated Chancre, instead of changing into the 
milder form of regular, or Hunterian Chancre, assume 
a phagedenic appearance, Merc, corros. sublimate will be 
required, as advised in this third Variety of Chancres, viz: 

III. The Phagedenic Chancre. — This is the most 
malignant and rapidly destructive form of syphilis; 
the chancre assuming this form, either from the primary 
intensity of the virus, or from the depraved condition of 
the system which it attacks, or from both these circum- 
stances combined. This ulcer, says Jahr, like the ele- 
vated chancre, has no induration. If the edges or base 
appear swollen, such swelling is nothing less than a 
malignant oedema (like most malignant erysipelas). The 
phagedenic chancre penetrates less into the subjacent 
tissues than it spreads in circumference. It may pre- 
serve its round shape ; but in the most cases it spreads 
about irregularly, assuming a Serpiginous character.* 
Usually the progress of the phagedenic chancre is 
marked by putrid disorganization ; but sometimes it be- 
comes converted into a gangrenous sore. In either case, 
this form of syphilis is rapidly destructive and dan- 
gerous. 

This form of syphilis nearly always grows worse under 
the usual preparations of mercury ; with the exception 
of the Corrosive sublimate. This, says Jahr, " has never 
left me in the lurch, although I never give it in larger 
doses than one half of a grain of the first centesimal 
trituration, morning and evening. This agent very 
*Jahr, Venereal Dis. p. 90. 



92 TRUE SYPHILIS. 

speedily arrests the ulcerative progress, but should not 
be repeated too often after symptoms of improvement 
have begun to set in, lest cicatrization should take place 
too rapidly and only superficially." When given in solu- 
tion, this powerful drug acts still more promptly upon 
the organism. SwainVs Panacea, which is claimed to 
have caused some wonderful cures, — and which is known 
to have caused some most f rightful deformities from such 
phagedenic ulceration, — is principally composed of this 
active poison. 

" So long as the original spot upon which the chancre 
has been developed, exhibits a reddish, morbid-looking, 
red or bluish scar, we may be sure that the internal dis- 
ease is not completely cured ; whereas, if the chancre has 
been removed by the internal remedy, the original spot 
of the chancre can no longer be traced on account of 
that spot being covered by as healthy colored a skin as 
the rest of the body." — Hahnemann.^ 

Treatment. — It cannot be too strongly impressed 
upon the reader, that the practice so frequently adopted 
of destroying the chancre by lunar caustic is one of 
the most fatal practices of the present day. It does not 
by any means follow, that, because we have suppressed 
the outward manifestation of the disease, we have there- 
by vanquished it. On the contrary, we have destroyed 
our most valuable guide, and we cannot possibly tell 
whether or when the patient is rid of his complaint. 
When we find the chancre yielding to the internal use 
of medicines, properly selected, we can be certain that 
the patient is in a fair way of recovery ; but when 
caustic or various repellents are employed, the disease 



TRUE SYPHILIS. 93 

becomes more intractable and complicated, secondary 
symptoms arise, or the patient is carried off by con- 
sumption, or suffers for the remainder of his life from 
some other chronic complaint, it being no uncommon 
thing to find persons attributing, and with good reason, 
all the miseries of ill-health they have undergone, to 
syphilis badly treated in bygone days. The proper 
remedy must be selected with reference to the form, ex- 
tent, and duration of the ulceration, the constitutional 
and moral disposition being taken into consideration. 

The greatest cleanliness is of course necessary ; a 
small piece of wet lint may be introduced between the 
glans and prepuce, when the ulcerations are not ex- 
tremely painful : otherwise, water should be injected 
under the folds of the prepuce, by means of a small 
syringe. Absolute rest is to be enjoined, if possible, 
(and always if the sore assumes a phagedenic type ;) 
neglect of this rule prolonging the disease, in spite of 
the best conducted treatment. 

Diet. — Young plethoric persons should practise ab- 
stemiousness in this complaint, but debilitated persons 
should use a generous diet, provided inflammatory symp- 
toms are not present, wine being allowed in cases of 
great depression and prostration of strength. Rice or 
barley-water, and cocoa, or weak black tea if accus- 
tomed to it, are the best beverages. 

Treatment. — "When Mercury has not been pre- 
viously employed, we prescribe it for all sores which 
present an indurated base and margin, whether they 
secrete and are covered with a tenacious, or a thin, 
offensive matter; and we should certainly most unwill- 
ingly dispense with this valuable remedy in such cases, 



94 TKUE SYPHILIS. 

notwithstanding the bad repute it has acquired, from 
the frightful effects which have so frequently arisen from 
its abuse in the hands of our allopathic brethren."* 

The more particular indications are : spreading and 
deeply penetrating ulcers on the glans and prepuce, or 
pale-red vesicles breaking into small ulcers on these 
parts ; the chancres bleed readily, are very painful, and 
secrete a yellowish-white fetid pus; ulcers with inverted 
red edges and a cheesy bottom, or circular ulcers with 
inflamed base, accompanied, in females, with swelling of 
the vagina. 

Merc, corros. is very useful in chancres with the 
ichor firmly adhering to the bottom of the ulcer, and 
secretion of thin pus, leaving stains on the linen as from 
melted tallow. 

Cinnabaris. We have found this medicine remarkably 
useful when no benefit has accrued from Mercurius, 
although apparently well indicated ; it is in scrofulous 
cases where it best displays its remedial powers. 

Acid nitric. This remedy, which ranks equally with 
Mercurius in this complaint, is to be employed against 
the chancre with raised edges, with a tendency to bleed 
easily and profusely, and where no signs of central 
granulation are present, or, if they are, instead of a firm 
and florid appearance, pale, flabby, and prominent, the dis- 
charge being generally thin. This remedy is very useful 
in those cases maltreated with mercurial preparations. 

Aconite is necessary (as an intercurrent remedy) when 
there is violent inflammation of the penis, following the 
exhibition of Mercury. When this occurs with chancres 
on the glans, it will be advisable not to retract the pre- 
puce, but effect the cure of the ulcer without exposing it. 

* Laurie's "Elements of the Practice of Physic," p. 482. 



TRUE SYPHILIS. 95 

Arsenicum is very appropriate in cases which, under 
the administration of Mercury, are filled up with florid 
but too elevated granulations, the margins of the ulcer 
remaining hard and bleeding at the slightest touch, the 
discharge being very thin and offensive. It cannot be 
dispensed with in the phagedenic variety where the 
ulcer presents livid elevations, which are jagged, sharp, 
and undermined, with intense burning pains, gangrene 
being imminent ; and is the principal remedy when the 
latter complication is established, characterized by ces- 
sation of the pain, livid or mottled appearance of the 
sore, and the formation of a black slough, which sooner 
or later separates, leaving either a healthy sore, or one 
which plainly indicates that the ulceration is still ex- 
tending. 

Silicea is required in many of these cases when the 
discharge is excessive, foul smelling, discolored, and 
bloody and thin, or the sore is inflamed and irritable, 
with unhealthy granulation. 

Argent, nit. is efficacious for little ulcers on the pre- 
puce, the margins of which are at first covered with pus, 
spreading gradually, and covered with a tallowy lar- 
daceous substance. 

Causticum is very good for chancres secreting an acrid 
corrosive pus, or a watery, greenish fluid, with complica- 
tion with cutaneous affections, gout, or scurvy. 

Sulphur, as an intermediate remedy, is extremely use- 
ful for chancres occurring in unhealthy individuals, 
where the disease threatens to assume a bad type, and 
particularly where the bottom of the ulcer is covered 
with the characteristic lardaceous secretion, with dis- 
charge of fetid ichor; but it is especially in the super- 



96 



TKUE SYPHILIS. 



ficial ulcer, with raised margins, that its greatest results 
are manifest. 

Thuja. This medicine is required in flat, itching 
ulcers, with unclean bottoms, or whitish chancres, with 
hard edges. In complications with gonorrhoea, Thuja 
is extremely useful. 



CHANCRE.— SYMPTOMATIC INDICATIONS. 



Acrid corrosive pus 

Bleeding readily, with ichorous secretion 

Burning pains in the chancres . 
Deep ulcers on the penis 
Edges resembling raw flesh 
Flat ulcer with red edges 
Florid chancres, with raised edges 
Gangrene of the penis . 
Gangrenous ulcers with bloody edges . 
Ichor adhering to the bottom of the ulcer 
Ichorous pus from chancres 
Inflamed circular ulcers 
Lardaceous ulcers, with white places in 
centre . 
edges, with fetid secretion 
Little ulcers, which spread gradually . 
Painless ulcer, with hard edges 
Red chancres on the prepuce . 
Secretion of copious watery fetid ichor 
Small chancres with clean bottoms 
Superficial ulcers and excoriations 
Torpid ulcers in cachectic individuals . 
Vesicles, pale-red 

smarting, on the labia 



. Arsen., Caust. 
. Ars., Carb. v., He- 
par s., Merc. 
. Ars., Calc. 
. Mercurius. 
. Mercurius. 
. Thuja. 
. Iodium. 

. Arsen., Lachesis. 
. Arsenicum. 
_. Merc, corros. 
. Aurum. 
. Mercurius. 
the 

. Arsenicum. 

. Hepar sulph. 

. Argent, nit. 

. Arsenicum. 

. Merc, Thuja. 

. Arsenicum. 

. Mercurius. 

. Sulphur. 

. Sulphur. 

. Mercurius, Thuja. 

. Staphysagria. 



BUBO. — Syphilitic buboes are classed as primary, 
secondary, or constitutional. The first appear commonly 
from the third to the sixth day of the infection, without 
premonitory symptoms ; secondary buboes arise from 
gonorrhoea, or as sequelae to syphilitic chancre; whilst 



TRUE SYPHILIS. 97 

constitutional buboes have for their origin an old infec- 
tion, overlooked during its development, and which has 
now become a constitutional disease. They are red, 
hard, and rather indolent tumors, situated in a conglo- 
bate gland, are very diffuse, suppurating with difficulty, 
the pus being discharged through an opening with a 
callous edge. Syphilitic buboes affect principally the 
glands of the groin, and of the arm-pit, (axilla,) and 
are produced from the absorption by the lymphatics of 
the contagious virus of the chancre. Sometimes several 
weeks elapse after the chancre has healed, and recovery 
has taken place, when the (secondary) bubo begins to 
develop itself. When the chancre is situated at the 
orifice of the urethra, or on- the frasnum, bubo in the 
groin is generally certain to follow ; should these two 
co-exist, constitutional syphilis is usually developed. It 
also happens that primary ulcers about the head and 
face are liable to give rise to these troublesome swell- 
ings, within a short distance of the affected parts. 
Primary bubo presents itself under three varieties, cor- 
responding pretty well to those of the chancre, viz., 
acute, indolent, and phagedenic. The first, which is 
inflammatory, terminates in suppuration ; the second, 
characterized by induration, does not readily gather, 
but runs a tedious course ; the last becomes a phage- 
denic, gangrenous ulcer, and is the most dangerous form 
of the disease. 

The symptoms of the acute bubo are the following: 
Violent inflammation of the gland, which becomes im- 
movable, attended with pain, and rapidly increasing 
swelling of the parts ; the cellular tissue around it be- 
comes infiltrated and indurated with the inflammatory 



98 TRUE SYPHILIS. 

exudation, the skin on the tumor is hot, shining, very 
sensitive, and a slight redness develops itself in the 
middle. When the suppurative process sets in, the ac- 
cumulated pus gives rise to a soft, oval swelling round 
the gland, which remains hard, and is not invaded by 
the suppuration till a late period. Febrile symptoms, 
and sometimes oedema (puffy swelling) of the abdomen 
and the internal surface of the thighs, accompany this 
affection. Rigors are present during the process, and, 
when completed, the fever abates, the pain grows less, 
and the motion of the limbs becomes more easy. 

The indolent bubo appears after primary, indurated, or 
constitutional chancre, and only when these are healed. 
It progresses very slowly, is scarcely painful, and the 
skin, unaltered in color or temperature, can be moved 
over the hard tumor. Much larger than the acute kind, 
these buboes remain unaltered for months, when the 
skin at length becomes hot, and suppuration commences 
in a portion only of the tumor. The pus is thin and 
flocculent, the skin changing from a bright-red to a 
bluish-red color ; fistulse often make their appearance in 
various directions, through which pus pours in consider- 
able quantities. 

The phagedenic bubo commences with violent erysipe- 
latous inflammation of the skin, spreading rapidly, and 
accompanied by violent pains in the tumor, with acute 
fever, intense thirst, and sleeplessness. The skin over 
the part rapidly assumes a livid or dirty brownish-yellow 
hue, and gangrene quickly supervenes, attended with 
great anxiety and prostration. 

[The exercise of walking tends in a remarkable man- 



TRUE SYPHILIS. 99 

ner to develop buboes in syphilitic patients; as it does 
to aggravate the discharge, and disposition to orchitis 
in those suffering with gonorrhoea. Such exercise, there- 
fore, should be strictly forbidden in either case. 

Jahr recommends Merc, rub., prsec. the red oxide of 
Mercury, in these cases, unless the patient has already 
taken a good deal of Mercury allopathically. Or, if the 
Prsec, rub. does not answer, he gives Cinnabar. (If 
the patient had been mercurialized already, he uses Au- 
rumj Nitric acid, or Hepar s.) If the first-mentioned 
remedies do not disperse the tumor, and the chancre 
does not demand immediate special treatment, he uses 
Carbo animalis for the bubo with the happiest result. 
If the chancre is in a fungous condition, Nitric acid 
will be preferable. If fluctuation has already set in, he 
begins the treatment with Carbo animalis; to be fol- 
lowed, if necessary, with Nitric acid. 

For gangrened buboes, Arsenicum may be used ; for 
old indurated buboes, which remain as a clean ulcer 
(scrofulous) after the extinction of syphilitic symptoms, 
Silicea, Sulphur, or Hepar s. 

Dr. Hempel * recommends the Deut-iodide or Bin- 
iodide of Mercury (the red iodide) very highly, in the 
first or second decimal trituration, as " a very efficacious 
remedy for chancre and bubo." But the practitioner 
who has not been in the habit of using the red iodide 
of mercury should remember that it is a very active 
poison, which, if not so corrosive as the sublimate, may 
be no less dangerous. A patient may easily be fatally 
poisoned with half-grain doses of the first decimal tritu- 
ration of the Deut-iodide of Merc. The first decimal 
* Jahrs Venereal Diseases, p. 136. 



100 TRUE SYPHILIS. 

(or second decimal) trituration will be found powerful 
enough, and will produce far more satisfactory results, 
in most cases, than the first decimal possibly can. 

The Iodide of potassium will also be found useful 
(in addition to the cases in which Berjeau recommends 
it) in persons who have been salivated, or otherwise 
severely mercurialized ; but it seems entirely unneces- 
sary to give it in the enormous doses (thirty grains in 
eight ounces of water, to which half an ounce of tinc- 
ture of iodine is added, and a desert-spoonful three times 
a day) advised by Dr. HempeJ. 

In some cases, buboes constitute a vicarious manifes- 
tation of the syphilitic disease in place of chancre. 
They need therefore to be carefully treated with the 
appropriate anti-syphilitic (or it may be the anti-mer- 
curial) remedy ; and to be radically cured by internal 
medication, in order that the patient may not presently 
find his last state (of secondary syphilis) worse than 
the first.] 

Mercurius corrosivus, Cinnabaris, Mercurius iodidum. 

These are the most prominent remedies for this compli- 
cation ; the first being principally required for acute bubo, 
the two latter being more efficacious in the indolent vari- 
ety. The principal indications are, inflammatory swelling, 
redness and painful sensitiveness of the inguinal glands, 
with suppuration, or ulceration, quickly taking place. 

Acid nitric, may be employed when Mercurius has 
failed to check the disorder, and particularly when the 
character of the chancre points to this remedy. 

Kali iodidum. This is required for scrofulous pa- 
tients, when neither of the former medicines seem to 



TRUE SYPHILIS. 101 

relieve. It is indicated by the swelling being very hard, 
indolent , and suppurating with difficulty, the discharge 
being curdy, and often discolored and foul -smelling. It 
is also very useful when there is thickening of the 
spermatic cord, occurring in complicated cases. 

Apis mell. is invaluable when the glands are violently 
inflamed, with red, hot, and shining swelling, accom- 
panied with great pain and sensibility; this medicine 
very frequently is sufficient to check the bubo imme- 
diately, although powerless against the syphilitic virus 
itself; this, however, is not to be wondered at, as the 
bubo arises from irritation, caused by the absorption of 
the virus. 

Graphite is requisite in debilitated individuals, par- 
ticularly females, when the swelling is painful and very 
sensitive. 

Hepar sulph.; Silicea. In suppuration of the gland, 
these two remedies will materially forward the process, 
and prevent the unsightly scars usually left at the ter- 
mination of the process. 

Thuja. Should the complaint be complicated with 
excrescences of the penis, or round the anus, the glands 
being painful, with drawing pains extending to the knee, 
this medicine will exercise a satisfactory influence. 

Arsenicum is indispensable in the phagedenic and gan- 
grenous form of the disease, attended with similar symp- 
toms to those of gangrenous chancre. ( Vide page 95.) 

Lachesis, Carbo veg., are frequently required, either 
singly or in alternation with Arsenicum, particularly 
when the prostration is excessive, the parts extremely 
livid or mottled ; or, in the case of the latter medicine, 
when comatose symptoms supervene. 
9* 



CONSTITUTIONAL SYPHILIS. 

ERYTHEMA. — This complaint, attended with ero- 
sions of the mucous membrane, affects principally 
the interior of the mouth and fauces, constituting iso- 
lated, circumscribed, dark-red or copper-colored, slightly 
elevated, inflamed spots, especially on the back of the 
palate, tonsils, uvula, pharynx, and larynx. The mouth 
and fauces become hot, and the patient feels a difficulty 
of swallowing, with burning sensation in the fauces, 
hoarseness, and pain when talking, the mouth and throat 
feel very dry, and the whole interior of the mouth is of 
a bluish-red. In the centre of the intensely red spots 
are insulated erosions, forming smaller spots, of a gray- 
ish-white color. The mucous membrane of the nasal 
cavity and the sexual organs are simultaneously affected 
in the same way ; and small tubercles arise upon a 
bright copper-colored base. These tubercles become 
eroded, and secrete a grayish, purulent, fetid fluid. In 
both sexes these erosions give rise to the formation of 
excrescences (condylomata.) 

Treatment. — Aurum is very useful in ill-looking 
ulcerations of the mouth and nose, secreting fetid pus, 
or for scabs in the nose, provoking an inclination to pick 
it, as well as for swelling of the labia (in women), which 
are covered with large red pimples. This remedy is one 
of the most valuable when the disease is complicated 
with mercurial symptoms. 

Arsenicum is requisite when the discharge is very 
offensive and corrosive, the ulcers liable to gangrenous 
degeneration. 

102 



CONSTITUTIONAL SYPHILIS. 103 

Kali iodidum. For scrofulous subjects, with tendency 
to ulceration, and also with discharge of corrosive burn- 
ing serum, and lancinating pains in the throat. This 
medicine is often required to combat mercurial symp- 
toms, arising from ill-judged and excessive doses of that 
metal in this complaint. 

JVIercurius. Small and itching spots, which ulcerate 
and become encrusted, bleeding easily, and secreting 
purulent and fetid matter. 

Acid nitric. Small, round ulcerations, bleeding easily, 
and attended with lancinations as if from splinters. 

Sulphur. In unhealthy patients, this remedy is very 
efficacious in completing the cure, after the employment 
of one of the before-mentioned medicines. 

TUBERCLES. — Syphilitic tubercles are divided into 
three classes, viz., cutaneous, mucous, and deep-seated. 

The cutaneous or flat kind are either single, or form- 
ing circular lines, and sometimes in groups or clusters ; 
they frequently accompany mucous tubercles, and are 
found principally on the scrotum, penis, mons veneris, the 
perinaeum, and round the anus, the inside of the thighs, 
and in the groin, the nape of the neck, the arm-pits, the 
hairy scalp, in the face, round the mouth, in the nostrils, 
on the forehead, between the toes, and along the nails, 
but seldom appear in more than two or three of these 
places at once, and the discharge from them is supposed 
to be contagious. They are of a bright-red copper-color, 
and almost always painless, and either assume a scaly 
form, or ulceration takes place, and they become covered 
with a hard crust, which, when detached, leaves a deep 
cicatrix. 



104 CONSTITUTIONAL SYPHILIS. 

Mucous tubercles occur most frequently in women and 
children, developing themselves on the mucous mem- 
brane of the female sexual parts, and in the mouth and 
fauces. They form flat, circumscribed elevations of the 
mucous membrane, which is engorged and thickened, 
secreting a tenacious, purulent fluid of a peculiar and 
extremely offensive odor. Sometimes several of them 
unite, forming irregularly shaped elevations ; the small 
ones, of the size of a millet-seed, are generally very hu- 
mid, regularly rounded, forming truncated cones, being 
of a brighter red color in the centre than at the. circum- 
ference, and frequently forming regularly shaped rings, 
especially on the glans, the inner surface of the cheeks 
and lips, and the tongue and roof of the mouth. The 
large mucous tubercles are raised about a line above the 
mucous membrane, forming oval, full^ tense, flattened 
elevations of a bright-red color, covered with a thick 
grajnsh-white layer of epithelium. When these tuber- 
cles form on the lining membrane of the nose, their 
effects are most destructive ; the intense irritation and 
itching causing the patient to believe he has caught 
cold, and consequently there is blowing of the nose, and 
perhaps scratching of the parts, which causes ulceration, 
liable, if not speedily stopped, to attack and destroy the 
whole surrounding parts, and even to endanger life by 
the implication of the bones, no portion of which can 
be reproduced, if once destroyed, causing the most 
frightful mutilations of the face. In these cases the 
mischief is aggravated by the acrid, corrosive, greenish, 
or bloody pus that is secreted from the diseased surface. 
Deep-seated tubercles and ulcerations of the mucous 
membrane are always preceded by a tuberculous thick- 



CONSTITUTIONAL SYPHILIS. 105 

erring of the mucous membrane and adjacent cellular 
tissue. The ulcers penetrate frequently to a consider- 
able depth, and are either isolated or in groups, with 
their bottoms covered with granulations, and, like the 
margins, covered with a grayish-yellow, creamy exuda- 
tion. Their usual seats are the neighborhood of the 
glans and fraenurn, and the entrance to the vagina and 
uterus. If neglected, they may perforate the whole 
thickness of the vagina, and cause recto-vaginal or ure- 
throvaginal fistulas ; when they occur on the gums, ton- 
sils, palate, or back of the fauces, at the glottis, or in 
the larynx, they may frequently terminate fatally. 

Treatment. — These tubercles will generally yield to 
either Acid nitric, or Mercurius, although a few doses 
of Aconite will be frequently required if febrile symp- 
toms exist. 

For mucous tubercles, the remedies most frequently re- 
quired will be, Argenti nit., Calc, Nitric acid, Puls., 
Thuja. 

When affecting principally the nose, Acid nit., Acid 
phosph., Argenti nit., Aurum, Calc, Kali carb., 
Kreasotum, Lycop., Merc corros., Puls., Rhus, 
Sepia, Staphysagria, and Thuja. 

For deep-seated tubercles, Arsen., Carbo veg., ISTatr. 
mur., Zinc 

These remedies should be collated with the Charac- 
teristic Effects, at the end of this work, and the preced- 
ing observations on Chancre, &c. 

EPHELIDES, MACUUE, Spots. — Ephelides are ex- 
tremely common, and appear very early, are generally 



106 CONSTITUTIONAL SYPHILIS. 

of a bright-red color, but occasionally are pale, coming 
out only in the cold, on the chest, neck, face, arms, inner 
side of the thighs, and the neighborhood of the genital 
organs ; they resemble measles and roseola, but are dis- 
tinguished from these by their persistence, measles dis- 
appearing after some days ; they develop themselves 
slowly, and grow larger at certain periods, e. g., after 
eating. If not cured before the ninth month from the 
time of their appearance, they assume the tuberculous, 
or scaly form. 

Treatment. — The principal remedies are, Antimon. 
crud., Antim. tart., Canth., Merc. ; or Aurum, Bell., 
Calc, Clemat., Lycop., Mezer., Petrol., Phosph. 
Vide the Characteristic Effects, at the end of this 
work. 

SQUAMvt, Scaly Eruptions. — These ^rise either from 
tubercles or spots, which change into large, irregularly 
shaped, confluent elevations, of a bright copper color, 
covered with hard, readily tearing scales of a dull white 
color ; this affection usually is found in the hollow of 
the hand (psoriasis palmaris) and the soles of the feet 
(psoriasis plantaris) ; ulcers are very liable to arise from 
this form of syphilis. 

Treatment. — The most appropriate remedies are, 
Acid nitric, Arsenicum, Hepar sulph., Kali iod., 
Mercurius. The indications for which will be found 
in the Characteristic Effects. 

RUPIA. — Is frequently a sequel to pemphigus, (an 
affection similar to that produced by the action of a 



CONSTITUTIONAL SYPHILIS. 107 

blister on the skin,) or to ecthyma, (a pustular erup- 
tion ;) although liable to break out, without any pre- 
monitory symptoms. In the former case it arises from 
not very tense blisters of a regularly round shape, about 
the size of a bean, and surrounded by a copper-colored 
areola ; they stand upon a swollen indurated basis, and 
contain a dark-yellow purulent fluid, which generally 
changes to a brownish color ; the pus dries up in the 
middle of the blister, and forms a small brown crust, 
around which the skin again arises in blisters, filled with 
a peculiar brownish-red, purulent fluid ; the crusts grad- 
ually acquire a conical or pyramidal shape, sometimes 
increasing to an extraordinary size. They are never 
very numerous, and are limited from twelve to twenty, 
scattered over the whole body. The course of this affec- 
tion is very tedious, and unless checked, the secretion of 
pus is very great, the digestive functions become im- 
paired, the strength is gradually undermined, and col- 
liquative diarrhoea announces the impending dissolution 
of the sufferer. Serpiginous and perforating tuber- 
cles are related to this form of syphilides ; the former 
are large and hard, assuming a tolerable roundness ; the 
latter exist only in small numbers, forming spheroidal 
rings on the skin, and penetrating to the subcutaneous 
cellular tissue, where they can be felt with the finger, 
as hard tumors. When these ulcerate, destruction of 
the skin is no unfrequent occurrence. They are gener- 
ally found in scrofulous patients with a delicate white 
skin, and appear on the face, the cheeks, round the nose 
and lips, in front of the ear, and on the legs. Serpigi- 
nous tubercles occur most frequently on the face, the 
nape of the neck, the head, forehead, shoulders, and 



108 CONSTITUTIONAL SYPHILIS. 

trunk. At first they have a bright, shining, copper- 
colored appearance, although never scaly ; but after- 
wards they become inflamed, ulcerating at their points, 
and afterwards covered with a thick, hard, conical, 
brownish or yellowish-gray, firmly adhering crust. 

Mercurius. Violent itching, renewed by the heat of 
the bed ; small and very itchy pimples, which ulcerate 
and become encrusted ; desquamation of the skin ; tet- 
tery, excoriated, and oozing spots which bleed easily 
when scratched. 

Acid, nitricum. Copper or violet-colored spots on 
the body ; lancinations in the parts, with burning pain, 
and bleeding readily ; sanious, sanguineous, or corrosive 
suppuration. 

Clematis. Fungous excrescences ; scabby tetters, which 
discharge a sanious pus, yellow and corrosive ; burning 
or tingling, and pulsations in the parfs ; insupportable 
itching of the parts in the heat of the bed. 

Sarsaparilla. When Mercury, in large doses, has been 
fruitlessly employed, this remedy will remove purulent 
vesicles, not numerous, but itching intolerably, the irri- 
tation causing depression of spirits. 

Sulphur. Scabious eruptions, with burning itching, 
surrounded by a yellow or brownish areola ; secretion of 
a sanious, fetid, or thick and yellow pus ; spots covered 
with small vesicles, discharging serous lymph. 

Thuja. Brown or red mottled spots, with itching 
shootings in the evening ; purulent pimples, containing 
fluid j ike varnish. 

ALOPECIA. — General or partial falling off of the 
hair, with furfuraceous desquamations, especially on the 



CONSTITUTIONAL SYPHILIS. 109 

head, spreading and coalescing. It arises gradually, the 
hair coming off when combed, or when pulled, exposing 
spots of a white or reddish shining hue ; finally, the 
whole cutaneous covering is involved, and every vestige 
of hair disappears, the skin being covered with thin, 
whitish or bright-yellow scales, which form anew if re- 
moved. Alopecia is, nevertheless, more a symptom than 
a disease in itself, and may arise during the course of 
many other complaints ; consequently, the history of 
the patient's case must be well considered, and meas- 
ures adopted for the eradication of the syphilitic dis- 
ease, before this affection can be possibly relieved, the 
cure of the one being generally followed by the removal 
of the other. 

Treatment. — Mercurius, Hepar, and Carbo veg. 
are the principal remedies to be trusted in the syphilitic 
form of the complaint, but other remedies may be re- 
quired, regard being had to the other S3 7 mptoms which 
always accompany it. ( Vide Characteristic Effects 
of the medicines.) 

IRITIS SYPHILITICA, Inflammation of the Iris. — 

This disease, which seldom affects but one eye, is distin- 
guished from the ordinary inflammation of this part by 
the presence of tubercles on the anterior surface of the 
iris. Iritis may be generally know^n in its first stage 
by the presence of a circular ring of injected blood-ves- 
sels round the cornea, with distortion of the pupil (gen- 
erally), which gradually contracts, and, if not speedily 
arrested, terminates in total and incurable closure. The 
iris becomes discolored, the cornea dim and hazy, noc- 
turnal pains are felt in the head, and the intolerance of 
10 



110 CONSTITUTIONAL SYPHILIS. 

light is great ; as the complaint progresses, the sclerotic 
(white part of the eye) becomes of a rosy color, the 
vessels being greatly enlarged and injected ; there are 
dull, pressive pains in the eye, with profuse secretion 
of tears ; the sight is also obscured and misty, the iris 
becomes more and more discolored, and is generally of 
a dirty-red hue, and exudation takes place upon its sur- 
face, in proportion to the severity of the complaint ; its 
free margin is swollen and thickened, and in very severe 
cases becomes attached to the anterior surface of the 
crystalline lens, (synechia posterior,) which, instead 
of presenting a black appearance, is of a grayish color ; 
the pupil becomes sensitive to light, immovable, con- 
tracted, and distorted, whilst pedunculated excrescences, 
termed condylomata of the iris, grow from its inner 
circumference. The pains in the head and eye, of a 
constrictive boring nature, extending to the surrounding 
parts, becoming worse towards evening, coupled with 
the malaise produced by the general disease, deprive 
the patient almost entirely of rest. Towards the termi- 
nation of the complaint, pus, or pus mixed with blood, is 
often found in the anterior chamber of the eye, and can 
be observed when the cornea is not too dim. 

Treatment. — This disease, if not properly treated, is 
very apt to produce serious disorganization of the struc- 
ture of the eye, with complete closure of the pupil, 
almost irremediable, if it has existed only a short time ; 
whilst adhesions to the cornea or capsule of the lens are 
utterly incurable, if not speedily relieved, and cause 
more or less disfigurement of the eye. It is very essen- 
tial to determine whether the patient has been previously 
under a course of mercurial preparations, as these, inju- 



CONSTITUTIONAL SYPHILIS. Ill 

diciously given, have a tendency to excite the complaint 
in persons subject to weak eyes. In these cases, the an- 
tidotes to Mercury are to be used, as directed below. 
Rest and confinement to a dark room, with total absti- 
nence from any work that might strain the eye, are 
absolutely necessary. 

Treatment. — Mercurius corros. and Cinnabaris 
are the two principal remedies, the Latter being used for 
scrofulous subjects. They should be employed when the 
sclerotic presents the characteristic rosy circle round the 
cornea, the pain being burning and cutting, with profuse 
lachrymation, the cornea becoming dim, and the iris 
showing signs of discoloration and contraction ; and in 
severer cases, when there is danger of exudation or the 
formation of pus. 

It will be necessary to watch carefully the effects of 
the medicine in this disease, and to change it if necessary, 
should the affection progress, as the further it advances 
the more difficult is the recovery. 

Belladonna. This remedy must be resorted to (as a 
palliative) should the contraction of the pupil not yield 
to the apparently well-chosen remedy, and is often impe- 
ratively necessary in neglected cases, when the pupil 
has almost closed. 

Acid nitric is to be substituted for Mercurius 
should the symptoms have arisen from abuse of that 
medicine, or the general symptoms point to its employ- 
ment. 

Thuja is requisite, either singly or in conjunction with 
Acid nit., when tubercles or small warts appear on the 
iris. 

Aurum is very useful in mercurial iritis, and is pre- 



112 TERTIARY SYPHILIS. 

ferable to Acid nit. when the moral symptoms, such as 
great dejectedness, tremulous fearfulness, or a desire to 
commit suicide, preponderate. 

Hepar sulph. is required when pus is formed (hypo- 
pion), or when mercurial symptoms are present. 

[The principal remedies in Iritis syphilitica, are Merc, 
sub. corros., Nitric acid, and Thuja.~\ 



TERTIARY SYPHILIS. 

GUMMATA SYPHILITICA, Gummatose Tumors.— 

The skin, subcutaneous or interstitial cellular tissue, and 
the mucous membrane are the principal seats of this 
affection, which is tedious in its progress and liable to 
relapses ; it belongs to the remotest stage of constitu- 
tional syphilis. Appearing as hard, round, or pea-shaped 
swellings under the skin, and increasing slowly in size, 
they take months to attain the size of a small nut, and 
are usually disposed in rows of four or six together, like 
beads, adhering by their upper surface to the skin, 
although they can be moved over the subjacent parts. 
After remaining hard a long time, they become soft, pus 
forms in the centre of the tumor, which, adhering to the 
surrounding parts, is enclosed as in a cyst ; the skin over 
the swelling now assumes a bluish, copper color, becomes 
thin, and finally gives way ; an ulcer is formed with sus- 
picious-looking edges, secreting a fetid ichor. When 
these occur on the tongue, they are liable to be mistaken 
for scirrhus or cancer ; the part becomes hard and knotty, 



TERTIARY SYPHILIS. 113 

and in talking or chewing its free motion is greatly 
impeded, but the absence of shooting pains and a reddish 
appearance of the iris, the invariable accompaniments of 
cancer, will suffice to distinguish them from that terrible 
complaint. 

Treatment. — The following remedies will be found 
the most appropriate: — Mezereum, Plumbum, Stra- 
monium, Ruta, Acid phosph., Calc, Graphite. 
(Vide Characteristic Effects, at the end of this 
work.) 

Belladonna will be found very useful when any inflam- 
matory symptom is present. 

Arsenicum, w T hen the swelling is livid, with acrid, 
offensive discharge. 

Carbo, in similar cases, with burning pains, cachectic 
constitution, and profuse unhealthy discharge. 

Cinchona, for debilitated subjects, with discharge of 
pus and great torpor of the parts. 

Mercurius is very needful in hard, indurated swell- 
ings, with unhealthy skin, or when attended with rest- 
lessness and pains in the bones. 

Aurum, when there are symptoms of mercurial com- 
plication, or in severe cases which Mercury has failed 
to relieve. 

ORCHITIS SYPHILITICA, Sarcocele Syphilitica, 
Syphilitic Swelling of the Testes. — This disease consti- 
tutes one of the first and most frequent symptoms of 
tertiary syphilis. It rarely affects but one testicle, and 
it is only in a few cases that premonitory symptoms 
occur; these consist of acute boring pain in the loins, 
usually at night, or there is painful pressure in the re- 
10* 



114 TERTIARY SYPHILIS. 

gion of the kidneys, and sometimes a sensation as if a 
knife were thrust through the flesh. Even when swell- 
ing of the testicle takes place, the patient is seldom 
aware of it. On examination we find one or more indu- 
rated nodes, and on pressure a small spot that is harder 
and less elastic than the other parts. The induration 
often spreads round about like a circular belt (cirsocele), 
or in other cases the hardness is only partial, but gradu- 
ally spreads till the whole testicle becomes involved. 
When there are no complications, and the disease runs a 
regular course, the epididymis remains unaltered for a 
considerable period, and can be clearly distinguished 
from the testicle proper, which seldom or never swells at 
all, and then only within certain limits. This disease is 
very regular in its progression, the testicle preserves its 
pear-shaped form, but feels harder tharr the other ; even 
the inequalities we discover with the finger preserve a 
certain regularity, constituting a progressive series of 
circular indurations as *soon as the swelling has reached 
three or four times the original size of the testicle. 
Should it attain a large size, it will often lose the sensi- 
bility it possesses in its normal shape. In these cases 
the epididymis, though not morbidly altered, is no longer 
perceptible. The swelling is now hard, firm, and in- 
elastic, pressure with the finger conveying the sensation 
of a massive fibro-cartilaginous, inelastic texture. Occa- 
sionally it is associated with hydrocele of the tunica va- 
ginalis, without any fever or general derangement of the 
functions. 

When the internal structure of the testicle is dis- 
organized, the seminal secretion gradually ceases, as 
well as the erections, which finally disappear altogether. 



TERTIARY SYPHILIS. 115 

Although this complaint may last for months, or even 
years, it never terminates in suppuration, nor does it 
transgress certain limits. Resolution either takes place 
spontaneously or in consequence of adequate treatment; 
but sometimes it happens that a diminution takes place, 
which progresses till the entire testicle disappears ; it will 
also happen that the swelling will change to a fibrous, 
cartilaginous, or even osseous, tumor. This disease is 
developed not only from syphilitic infection, but also 
from injuries, excessive sexual indulgence, exercises hav- 
ing an irritating or exciting influence upon the testicles, 
or from gonorrhoea contracted during the course of 
secondary syphilis. If syphilis is complicated with a 
cancerous or scrofulous diathesis, this complaint is very 
easily developed. It is also found complicated with all 
sorts of disorganizations, such as varicocele, hydrocele, 
orchitis gonorrhoeica, cysts, and hydatids. 

Treatment. — In this disease, as in many others hav- 
ing a syphilitic origin, it will be highly necessary to 
study the whole history of the case previous to selecting 
any remedy, as it will be often very difficult to choose 
the appropriate medicine. The following remedies are 
very efficacious in the various phases of the disease. 

Arsenicum, Cinchona, Acid phosph., Plumbum, are 
particularly indicated if the general constitution seems 
to be broken down, or the disease has been aggravated 
by excess. 

Belladonna, if symptoms of inflammatory congestion 
develop themselves in the tumor. 

Clematis, Copaiba, Mercurius, Pulsatilla, when gonor- 
rhoea was the immediate cause of the disease, or at any 
rate had complicated or aggravated it. 



116 TERTIARY SYPHILIS. 

Graphite, Conium, Lycopodium, Belladonna, when the 
disease is complicated with general scrofulous glandular 
swellings, chronic eruptions, or from the suppression of 
the latter by improper applications. 

The other remedies which can be consulted with ad- 
vantage are Aurum, Gale, Garbo veg., Kali carb., 
Spongia; or, Acid nitricum,, Barytas carb., Mercurius, 
Mezer., Rhododendron, Rhus tox. {Vide Character- 
istic Effects. 

OSTITIS; PERIOSTITIS. — The tertiary syphilitic 
affections of the bones may be divided into four stages: 
periostitis, or inflammation of the membrane covering 
the bone; ostitis, or inflammation of the bone itself; 
exostosis, a bony tumor 'protruding from the bone; and 
caries, with necrosis, rottenness, and total death of 
the affected part. Syphilitic bone-pains may affect any 
portion of the osseous tissue, either superficial or deep- 
seated, in the flat or long bones, and in the periosteum; 
it is, however, in the superficial portions that they occur 
most frequently. These pains may occur ten or twenty 
years after the contraction of the disease, during changes 
in the weather. They are always aggravated towards 
night, and when the patient is warm in bed. Rjcord 
says that among the rich who spend the summer in the 
country and the winter in town, the pains are more felt 
at night in the summer, and in the daytime in winter. 
In most cases, if the patient goes to bed in the evening, 
the pains commence about 11 o'clock, and continue until 
2 or 3 o'clock the next morning. They commence with 
a disagreeable sensitiveness, which gradually increases 
to a pain, until it finally changes to a frightful torture. 



TERTIARY SYPHILIS. 117 

This pain is always seated in one spot, and reappears 
constantly in the same place. The least pressure causes 
an aggravation, which is not the case with a simple 
rheumatic pain. These pains are very often the pre- 
cursory symptoms of material changes in the bones, 
terminating in periostitis. After these pains have con- 
tinued for some length of time, alterations in the tissue 
of the periosteum begin to develop themselves. It be- 
comes inflamed, and exudations become distinctly per- 
ceptible when pressing on the part. The exuded matter 
is yellowish at first, of a gelatinous consistence, and, 
after a while, changes to a reddish or brownish fluid, 
mixed with extravasated blood. 

Periostitis generally appears in the region where the 
pain has been felt. A rather circumscribed swelling 
appears at this place, with its base firmly adherent to 
the subjacent bone, the skin over this swelling being 
movable and its color unaltered. Gradually the swelling 
increases to the size of a pigeon's or hen's egg, being 
rather firm at first, and does not fluctuate ; but when 
pressed upon does not impart the sensation of a resisting 
bone. If no suitable treatment is instituted, osseous 
degeneration (vide Exostosis, p. 119) may take place. 
Ostitis is characterized by pain more or less severe, 
attended with swelling and redness of the surrounding 
tissue. The presence of fever depends greatly on the 
state of the patient's health, and is generally worse, in 
conjunction with the pain, towards evening. If not 
speedily checked, it will most likely terminate in caries 
or suppuration of the spongy portion of the bone. 



118 TERTIARY SYPHILIS. 

[It should be remembered that, with scarcely an ex- 
ception, both Periostitis and Exostosis result from the 
previous exhibition of large doses of Mercury. 

In many of these cases, very high potencies of Mercu- 
rius may be found useful; in others, the best indicated 
antidote to Mercury should be selected, especial refer- 
ence being made to the particular part of the system 
affected: for the remedy which would remove a difficulty 
of either kind (peri- or exostosis) on the long bones 
might not avail on the skull.] 

Treatment. — Mercurius is the principal remedy in 
the first stage of the disease, provided that it has not 
been previously used to excess. 

Kali iodidum is to be preferred when Mercury has 
been taken in large quantities, or the disease has arisen 
from the abuse of that remedy. 

Acid nitric, is recommended when Mercurius does 
not succeed, although apparently well indicated. 

Lachesis is very useful when mercurial preparations 
have been abused, or that medicine proves ineffectual 
with lividity of the skin, and great tenderness on pressure. 

Mezereum, Staphysagria, may be employed when the 
part where the pain is located feels sore, as if ulcerated. 

Arsenicum, Calc. carb., Phosphorus, Sulphur, in cases 
where there is great debility, or tendency to scrofula. 

The following remedies are also worthy of attention: — 
Acid fluoric, Acid phosph., Caust., Kali carb., 
Lycopodium, Natr. mur., Platina, Plumbum, Pe- 
trol., Pulsat., Rhodod. {Vide Characteristic 
Indications. 



TERTIARY SYPHILIS. 119 

EXOSTOSIS, — This term is applied to any unnatural 
protuberance on a bone, constituting a tumor, inelastic, 
immovable, hard, and bony to the touch ; seated on the 
substance of a bone, it is sometimes composed of bony 
spiculae, resembling crystallizations; at others it is ex- 
quisitely hard and smooth, resembling ivory. Although 
very rough at first, the older it becomes the smoother 
and more polished form does it assume. They are found 
in various shapes; round, knotty, fusiform, or even 
pedunculated. 

It occasionally happens that the exudation takes place 
in the interior of the bones (exostosis), in which case 
the part assumes a very hard consistence, like ivory, 
and the cavity of the bone is often obliterated, whilst 
its diameter is materially increased. In the syphilitic 
varieties of this disease, periostitis is always the pre- 
cursor. Directly the bone begins to swell, the pains 
commence to subside ; but the patient is variously incom- 
moded according to the seat of the disease; locomotion 
being impeded when occurring on the legs or feet, or 
paralysis may be induced if the morbid growth invades 
the inner portion of the skull. 

Treatment. — Mercurius is here again one of the 
principal remedies, and is to be employed at the outset, 
when the swelling commences to form, and the pains in 
the bones are very violent towards night. 

Acid nitricum should be substituted for Mercurius 
when that remedy has been taken to excess, or does not 
appear to influence the complaint. The pains indicating 
this medicine are generally drawing and pressing, par- 
ticularly in the bones of the head. 

Silicea is very useful in swelling of the bones, espe- 



120 TERTIARY SYPHILIS. 

cially of the lower jaw, or when the spine is swollen and 
distorted. 

Staphysagria, when the patient is debilitated, and suf- 
fers from swelling of the bones of the face and feet. 

Aurum, in cases of mercurial poisoning, or when the 
head and face are the chief seats of the disorder. It is 
very useful when the nose is implicated.* 

Mezereum is to be given when the disease is preceded 
by pains aggravated by touch, and principally seated in 
the bones of the face, thighs and legs. 

Ruta, often required in alternation with the latter 
remedy, is invaluable in those cases where the premoni- 
tory pains partake of a contusive character, and there are 
burning, gnawing pains in the bones of the legs, feet, or 
head. 

Sabina is very efficacious when the disease affects the 
hollow bones, and more remotely those of the hands and 
feet. The pain is generally lancinating, or drawing, and 
tearing. 

Asafcetida, Phosphorus. In affections of the long, 
hollow bones, attended with numbness, these two reme- 
dies, either singly or in alternation, are frequently re- 
quired, particularly for cachectic subjects. 

Kali iodidum in scrofulous cases, and particularly when 
complicated with mercurial disease. 

[For bone-pains, ostitis and periostitis, Jahr advises 
Mez., Phosph., Staph., Phos. ac., Nit. acid, Aurum, 
Guiacum. 

For swelling of bones, periostoses, exostoses — Aurum, 
Fluoric acid, Phosph., Staph., Mez., {Gale, c.,) Silic, 
Sulph., Phos. acid. 

* Jahr gives Aurum in the third trituration, one half a grain 
every four days. 



TERTIARY SYPHILIS. 121 

The osteocopus nocturnus, or mer curio-syphilitic bone- 
pains at night, are often relieved by large doses of Kali 
iodidum, in solution, when nothing else will. Sometimes 
these pains seem to be rheumatic in their nature ; always 
they are worse in damp and wet weather. Ten or even 
fifteen-grain doses afford very strongly marked relief to 
sufferings, which, resulting from the combined influences 
of syphilis and mercurial drugging in a scrofulous con- 
stitution, no earthly medication can entirely remove. I 
have used grain doses of the first trituration of this drug 
in such cases with great benefit.] 

CARIES AND NECROSIS. —Another of the remote 
forms of the syphilitic process, unfrequently met with, 
but extremely pernicious, is caries, which invades the 
bones, after overlooked or badly treated syphilitic in- 
flammation of the parts. It is principally the bones of 
the head, the leg-bones (tibia), the breast-bone (sternum), 
palate, and bones of the nose that are liable to be im- 
plicated. When the bones of the skull are affected, the 
greatest danger exists, as, should they be destroyed, their 
reproduction is impossible. Caries manifests itself by 
obtuse pains deep seated in the bones, the superincumbent 
integuments being discolored, flabby, and tender to the 
touch ; ulceration of the soft parts then commences, and 
ichor, thin, acrid, and dark-colored, flows from sinuses in 
communication with the caries. The diseased part pre- 
sents varied appearances, according to the nature and 
type of the complaint. Sometimes the bone is full of 
small holes (worm-eaten caries), or is soft and moist; 
or, at other times, it is dry, brittle, and of a grayish- 
white color. When necrosis (death of the bone) takes 
11 



122 TERTIARY SYPHILIS. 

place, the pain is extremely violent and deep-seatod ; an 
abscess soon forms over the affected part, which bursts, 
and fistulae open which will not heal till the dead portion 
of the bone is removed ; when the abscess bursts, co- 
agulable lymph is effused round the bone, which, in con- 
junction with the cedematous condition of the cellular 
membrane, forms a swelling of a hard, unyielding char- 
acter. 

Treatment. — Silicea is one of the most prominent 
remedies in these diseases, and is to be employed when 
the abscess is formed, and the pus is thick, dark colored, 
and offensive. It is invaluable when the dead portion 
of the bone is still adherent to the living part (second 
stage), or when it becomes loose (third stage), and the 
discharge of pus and ichor is excessive. 

Hepar sulph. is often required when there is putrid 
ulceration or discharge, smelling like decayed cheese. 
It is especially useful when the bones of the face are 
implicated. 

Lycopodium is useful, as an intermediate remedy, when 
the discharge is of a bright lemon-yellow color. 

Aurum, Acid nit. These two are specially indicated 
when the bones of the nose are implicated. Aurum is 
requisite when there is nasal speech, the bones of the nose, 
os frontis, and upper jaw swollen and reddened, with dis- 
charge of stinking ichor and small pieces of bone, ulcers 
on the palate, and offensive discharge from the ears, and 
rending pains in the bones of the extremities. 

Acid nit. is more useful when the patient suffers from 
previous mercurial treatment, or when there is inflam- 
mation and painful sensitiveness of the bones, with sani- 
ous and corrosive discharge. 



TERTIARY SYPHILIS. 123 

Belladonna is required as a palliative when the skin 
assumes an erysipelatous appearance, with thirst and 
fever. 

Phosphorus is needed, sometimes in conjunction with 
Mercurius or Staphysagria, when the bones of the 
face, and particularly the jaw, are affected. There is 
always great pain and swelling of the parts, with exfolia- 
tion of pieces of the bone. In patients of a scrofulous 
habit, one or other of these remedies is almost always 
requisite. 

Mezereum, Asafcetida, are principally required when 
the shin-bones are affected, and there is pain, swelling, 
and softening of the bone&, with serous, fetid, and san- 
guineous suppuration. 

Acid fluoric. This remedy, which appears to exercise 
a great influence on diseases of the bones in general, is 
very useful when the pains are burning and intermittent, 
with discharge of thin, acrid ichor, and great swelling 
about the diseased part, caries of the temporal bone. 
Caries from syphilis or mercury. [After abuse of 
Silicea.'] 

Arsenicum is of great use in very debilitated cases, 
and when the antrum highmorianum (the cavity in the 
upper jaw) is affected, with insupportable burning pain, 
and great depression of the vital powers. 

Calcarea, Sulphur. In scrofulous subjects these reme- 
dies will be frequently required, particularly when the 
medicine, although apparently well indicated, does not 
seem to exercise any appreciable effect. 

Should the disease increase in spite of the means 
employed, and serious irritation of the system set in, an 
operation for the removal of the part is indispensably 
necessary. 



124 CACHEXIA SYPHILITICA. 



CACHEXIA SYPHILITICA.— This is one of the re- 
motest forms of constitutional syphilis, and is a diseased 
state in which the whole habit of body is manifestly 
altered. After having first attacked the skin and mucous 
membrane, then the serous membranes and the bones 
and muscles, the virus at last invades the fleshy organs, 
the lungs, liver, spleen, kidneys, and even the heart and 
brain. The general symptoms of this disorder (but re- 
cently attributed to its real cause) are the following: 
The skin becomes sallow, yellowish, or livid ; the muscles 
waste; the strength fails; sight and hearing gradually 
diminish ; and the patient experiences violent palpitation 
of the heart, and chlorotic symptoms. Should the liver 
be more particularly affected, jaundice sets in, which may 
lead to suppuration of this organ, and finally to dangerous 
inflammation of the peritoneum. When the blood and 
blood-vessels are invaded, remittent fever, sanguineous 
extravasations under the skin, scurvy, and effusions of 
blood in the lungs and intestines, &c, supervene, followed 
by general dropsy. Ricord adds his testimony to 
Hahnemann's observations on latent syphilis, when he 
advises an antisyphilitic treatment to be instituted for 
inexplicable, deep-seated, mysterious, disguised derange- 
ment of the functions, even when there is no reason to 
suppose that the mischief arises from syphilitic taint. 

The symptoms of this complaint are so numerous, and 
vary so much with the patient's idiosyncrasy, that only 
the principal remedies can be indicated. It is also neces- 
sary to observe that those remedies which are mentioned 
for particular isolated symptoms, and not being of that 



CACHEXIA SYPHILITICA. 125 

class which are curative in syphilis proper, are only- 
palliative, and are not to be depended on for the eradica- 
tion of the complaint. 

[It is important that the practitioner remember in all 
these cases that his patients need not only the best 
possible medication, but also (and if possible still more) 
the best possible adaptation of external influences. A 
dry climate is indispensable. Xo physician need expect 
to see a patient suffering under general syphilitic cachexia, 
combined, as this usually if not always and invariably 
is, with mercurial demoralization of his constitution, im- 
prove in any perceptible manner, unless he is favored by 
residence in a dry and warm climate, and unless, also, he 
is supplied with suitable diet,' and freedom from anxious 
cares. In many such cases advice is of vastly more 
consequence than medicine ; and at any rate the latter 
without the former will do no good. Pure air, a dry, 
warm climate, suitable food, and other accessories to a 
careful and strictly homoeopathic medication (and if this 
latter be confined to the administration at long intervals 
of single doses of the highest potencies, so much the 
better) will sometimes do wonders in such cases. But 
both physician and patient must " learn to labor and to 
wait;" they must be both patient and persevering.] 

Treatment. — Merctjrius is one of the principal re- 
medies, and can be employed when there is emaciation 
and atrophy of the whole body, with slow or hectic 
fever ; swelling and hardness of the liver, with complete 
jaundice; or for circular ulcerations in the skin, mouth, 
and throat, and disorganization of the tonsils; livid, 
11* 



126 CACHEXIA SYPHILITICA. 

sallow, or copper color of the skin ; pains in the bones, 
and urine depositing a whitish or purulent sediment; 
sensation of indescribable malaise; low spirits; peevish, 
irritable temper. 

Acid nitricum is indicated where there are signs of 
general decomposition of the fluids, with scorbutic symp- 
toms in the mouth and salivation, the gums being ulcer- 
ated and bleeding; falling off of the hair, and ulcerated 
soreness of the scalp ; difficulty of hearing and smelling, 
the nose being ulcerated, with yellow, fetid discharge ; 
the larynx being dry, producing hoarseness, frequently 
accompanied with cough and expectoration of coagulated 
blood ; general indisposition, and feeling tired of life ; fits 
of anguish, accompanied with palpitation of the heart. 

Arsenicum. In desperate cases, in which there is rapid 
emaciation and debility, the disease showing a malignant 
disposition, there being dropsical effusjon of the whole 
body, trembling of the limbs, on which are malignant 
ulcerations with acrid discharge, and often fetid or ex- 
hausting bloody diarrhoea with continual urging, the skin 
being livid or covered with scales. It is also very useful 
in those cases where there is an indescribable feeling of 
illness with no particular symptoms, but where there is 
evidence of serious, though unseen, mischief. The moral 
symptoms are generally either melancholic and sad, or 
there is great restlessness and anguish, with fear of 
death, and excessive sensitiveness. 

Cinchona is very useful when there is a tendency to 
jaundice, with yellow color of the skin, great depression 
and debility, with tendency to dropsy, and attended with 
heat and chills ; the head is confused, and there is indis- 
position to work ; the spirits are low, with sadness and 



CACHEXIA SYPHILITICA. 127 

hopelessness, and often attended with great nervous 
irritation. 

Carbo veg. is requisite when the digestive organs are 
impaired, with acidity of the stomach and great flatu- 
lence, the skin being yellowish, and there are shooting 
pains in the liver and spleen, and often when there is 
palpitation of the heart ; the patient complains of lassi- 
tude and great weariness, his intellects are clouded, dull 
and confused, and his temper irritable and impatient. 

This remedy is very important in rousing the dormant 
energies, and developing symptoms which before were 
masked, and which are valuable and often indispensable 
to the proper selection of the appropriate remedy. 

Phosphorus, Acid Phosph. These remedies are very 
useful when the skin, bones and lungs are invaded ; 
when there is dry cough with or without sanguineous 
expectoration, heat in the chest, and a tendency to con- 
sumption ; or for affections of the ends of the long bones 
of the jaw, with nocturnal burning pains, and threaten- 
ing caries ; or in inveterate ulceration of the skin, with 
secretion of bad pus, and burning, stinging pain in the 
parts. There is also a feeling of weakness, as if proceed- 
ing from the loss of animal fluids. 

Sulphur. In obstinate affections of the skin, attended 
with bleeding of the gums, salivation, rheumatic pains in 
the limbs, small ulcerations on the leg, and disturbance 
of the functions of the liver and stomach. 

Plumbum is very useful for general emaciation, 
attended with hectic fever, paleness and flabbiness of the 
muscles, and great debilit}^ and also when there is pal- 
pitation of the heart and difficulty of breathing. 

Kali iodidum, Hepar sulphur. These remedies are 



128 SYPHILIS OF LITTLE CHILDREN. 

required in scrofulous cases, where the system is in bad 
condition, and there is reason to fear mercurial complica- 
tion ; they are especially useful in ulcerations and effu- 
sions of fluid into the cellular tissue, or when abscesses 
threaten ; and in induration of the liver they will often 
procure speedy resolution. 

The other remedies that may be consulted with advan- 
tage are Calc, Iod., Kali carb., Lycop., Sepia, and 
Thuja. ( Vide Characteristic Effects.) 

SYPHILIS OF LITTLE CHILDREN. Constitutional 
syphilis can be transmitted by the father or mother to 
the foetus, but infants are seldom infected during the pas- 
sage through the vagina ; for the first three weeks a child 
so infected seems robust and healthy, but afterwards the 
first signs of the disease make their appearance. The 
little patient is uneasy, and cries continually, emaciating 
very rapidly, and looking old and withered. [In some 
cases the infants look old and withered from birth ; they 
never increase in weight, but grow lighter till they die, 
in the course of three or four months, or less. Such 
cases no medication can save ; nor indeed is it desirable 
that such diseased persons should grow up. — Note by 
Editor.] The eyes being deeply sunk; circumscribed 
spots, of a bright copper color, rising speedily above the 
skin, in the shape of blotches, and sometimes running 
together, appear in the region of the sexual organs, in the 
groins, on the thighs, buttocks, heels, soles of the feet, 
round the anus, about the navel, and sometimes over the 
whole skin. Soon after, the palms of the hands are like- 
wise invaded, and simultaneously a papulous eruption, 
which afterwards changes to small, dirty, yellowish pus- 



SYPHILIS OF LITTLE CHILDREN. 129 

tules, surrounded by a broad areola, breaks out on the 
chest, back, face, and the hairy scalp. Tuberculous ele- 
vations start up on the inflamed portions of the feet, 
hands and anus. Sometimes these eruptions disappear 
without any medical treatment, but oftener superficial 
ulcers show themselves in the corners of the mouth, and 
in the nose, from which flows a discharge, which at first 
looks like catarrh. This discharge gradually increases ; 
the margins of the eyes and the meibomian glands be- 
come inflamed and suppurate ; the voice sounds hoarse, 
feeble, and moaning ; the breathing is accompanied with 
slight rattling, and — the nose being stopped by crusts — 
is performed through the mouth ; the ulcers deepen and 
extend, their edges being raised, and suppuration takes 
place. Ulceration likewise affects the fauces, rendering 
deglutition painful and difficult ; should the disease still 
progress, acute tuberculosis of the brain is apt to arise ; 
but should it escape this evil, anaemia slowly supervenes, 
and the child dies. 

Treatment. — The first and most important rule for 
treating children infected with this disease, is to remove 
them from the mother or nurse who is suffering from the 
same complaint. Should this be found impossible, the 
sick mother or nurse must be treated simultaneously and 
with the same remedies as the child. Cleanliness is in- 
dispensable, as well as the use of tepid baths every day, 
and the patients should be kept in a rather elevated tem- 
perature. The child is to be treated according to the 
symptoms manifested, in the manner prescribed in treat- 
ing of syphilis. Should a mercurial preparation be re- 
quired, the use of Cinnabaris (Mercurius bisulph.), 
or Merc, pr^ecip. rub., is to be preferred to the other 
forms of the medicine. 



SYCOSIS. 

THIS is a disease distinct from syphilis in its mani- 
festations, and partaking of a different character, al- 
though arising from impure connection. Although liable 
to be suppressed by the violent means used to remove its 
external signs, it never produces such ravages upon the 
constitution. It consists of excrescences resembling 
warts, sometimes dry, but generally soft, spongy, and 
similar to cauliflowers or cocks-combs. A fetid fluid is 
secreted from them, and they are liable to bleed upon the 
least irritation. At the same time there is usually a 
painless, thick, and purulent discharge from the urethra, 
and the penis is more or less indurated; attended with 
swelling of the lymphatic glands on its dorsum. 

When badly treated, either by Merotry or other re- 
medies having no relation to the disease, analogous ex- 
crescences arise on various parts of the body, sometimes 
consisting of white, flat, spongy elevations, seated in the 
mouth, lips, tongue, or fauces ; or of large, prominent, 
brownish tubercles, situated in the armpit, or the neck 
and scalp ; or again, retraction of the flexor tendons, par- 
ticularly of the fingers, will often supervene. 

[Condylomata or Fig-warts appear in connection 
with gonorrhoea ; or with syphilis ; or by themselves. 
To this independent affection the term Sycosis is ap- 
plied by Hahnemann. He uses the term differently 
from ordinary allopathic writers, who principally apply 
it to a peculiar fig-shaped eruption on the chin. Sycosis 

Menti. 

130 



SYCOSIS. 131 

Fig-warts grow about the genitals and anus, at the 
junction of the external skin with the mucous membrane : 
they may be flat ; conical ; growing on a pedicle, or small 
stem ; or appear like a cocks-comb. They are dry, or ex- 
ude a slimy, acrid, badly-smelling and contagious fluid. 

In syphilitic condylomata, the principal remedies are, 
Thuja, Nitric acid, and Cinnabar. 

Moist, itching condylomata, Psorin.~\ 

Treatment. — It is much to be recommended that no 
external application should be applied to the warts, as, 
in such instances, we are unable to judge of the effects of 
the internal remedy, and whether the disease is really 
yielding to the means applied, as it is easier to suppress 
than to cure this affection. 

Thuja. This remedy, in simple, uncomplicated cases, 
will generally suffice to entirely remove the symptoms ; 
should, however, the patient have been previously 
drugged with Mercury, Acid nitric, will be required, 
either singly or in alternation. In sycosic buboes these 
two remedies are also of great service, although Staphy- 
sagria, Sulphur, or Mercurius may be required. 

[This is the principal remedy in condylomata ; and it 
is suited to each of the three varieties, of simple or un- 
complicated, gonorrheal, and syphilitic sycosis, or fun- 
goid syphilis. The thirtieth, and still higher potencies 
have proved remarkably efficacious. 

According to Jahr, " the chief sphere of action of this 
remedy, and the modifications of the chancre virus that 
are described as idiopathic condylomata, mucous tuber- 
cles, and sycosic excrescences" also in " mucous tubercles 
on the labia, at the anus, in the corners of the mouth, on 



132 sycosis. 

the alee nasi, eye-lids, and nipples ; especially in the case 
of women and children." 

A gonorrheal patient of my own, an hostler, had large 
and abundant condylomata on the prepuce, of long stand- 
ing and very troublesome. I gave him a small vial of 
mother tincture of Thuja ; from this he made a single ap- 
plication externally, and broke the vial in his pocket be- 
fore he made another. But all the fig-warts had disap- 
peared, in the course of a week or two, when he came to 
report ; and they did not return. 

Euphrasia. — Tincture, externally applied, with suc- 
cess, by Miiller, of Leipzig, in broad condylomata in ano 
— when Thuja, Nit acid, and Cinnabar, had proved in- 
efficient. 

Eiickert, Therapeutics, p. 401, mentions two cases of 
fig-warts cured by its external and internal use. 

In moist, suppurating fig-warts, Euphrasia is men- 
tioned among other remedies, by Bane, p. 390.] 

[Nitric Acid. Has cured " dry pedicular excres- 
cences on the foreskin, and in the furrow behind the 
glans, which were almost an inch in length. The whole 
glans, the inner surface and the margin of the foreskin 
were bordered with innumerable excrescences, looking 
like raw flesh, from the size of a pin's head to that of a 
hazle-nut, bleeding and secreting when touched ever so 
lightly, and exuding a purulent matter of a disgusting, 
sweet odor." Nitric acid is affirmed by Jahr to be the 
chief remedy in syphilitic condylomata. The pus, which 
is secreted in large quantity, is corrosive, smells like 
brine, and causes a furious itching. It is indicated still 
more strongly in mercurialized patients ; and where 



sycosis. 133 

buboes are present. Also in flat fig-warts ; in those com- 
plicated with gonorrhoea ; and in mucous tubercles, or 
fungoid syphilis.] 

Mercurius. This medicine is only to be employed 
when the case is complicated with syphilis, and is very 
frequently required to be alternated with Sulphur. The 
indications for these remedies will be found fully set forth 
in the article on " Syphilis." 

In the secondary stage, when Thuja and Acid nitric 
have failed in relieving the patient, in consequence of 
complications with some dyscrasia, the following remedies 
may be consulted with advantage : 

Sulphur is very useful when the sore throat, enlarge- 
ment and ulceration of the tonsils, hoarseness, stains on 
the skin, or scaly spots have not yielded to the former 
remedies ; it is especially indicated when shooting pains 
are experienced in the joints, the flexor tendons of the 
fingers retracted, the lips tumefied, and the tongue red, 
rough, and fissured. 

[Cocks-comb-shaped, soft, spongy, readily-bleeding 
excrescences on the corona glandis ; moist warts and con- 
dylomata on the hard swollen labium.] 

Lycopodium can be employed for superficial whitish 
ulcerations of the tonsils, the tongue being fissured and 
covered, together with the interior of the mouth, with a 
scaly eruption. Lycop. 200 , has cured condylomata on 
the penis. 

Staphysagria. This remedy is of great service for 
moist and soft excrescences, the gums being soft, swollen, 
and spongy ; and for dry, or cocks-comb-shaped fig-warts 
and mucous tubercles. 
12 



134 sycosis. 

Sabina is very useful for large, moist and painful 
warts, even when free from contact. 

Acid Phosph. has been recommended for old warts 
which have been only slightly benefited by previous 
treatment ; and in mercurial syphilis with condylomata. 

Cinnabaris. In old and complicated cases, with en- 
largement of the tongue, and swelling and ulceration of 
the tonsils, with other symptoms apparently indicating 
the presence of syphilis, to which this complaint some- 
times bears a resemblance, this remedy is often of efficient 
service. 

[From Raue's Pathology and Therapeutics, p. 390, we 
take the following therapeutic hints : 

Fig-warts complicated with gonorrhoea, require : Thuja, 
Merc, corros., Cinnabar., Nit. acid, Sulphur, Lycopo- 
dium. 

When complicated with chancre ; Cinnab., Nit. acid, 
Phosph. acid, Staph., Thuja. 

When flat ; Magn., Nit. acid, QSabina.^) 

When exuberant, like cauliflowers ; Thuja, Staph. 

When fan-shaped ; Cinnabar. 

When pediculated ; Lycop., Nit. acid. 

When conical ; Merc. sol. 

When dry ; Thuja, Staph., Merc, sol., Merc. sub. corr., 
Nit. acid, Lycop. 

When moist, suppurating; Nit. acid., Thuja, Sulphur, 
Euphrasia. 

When soft, spongy ; Sulphur. 

When intolerably burning and itching ; Sabina.~\ 



NON-SYPHILITIC DISEASES. 

SPERMATORRHOEA; Involuntary Seminal Emis- 
sions. — This disease consists of an involuntary discharge 
of semen, taking place either during stool, on emission 
of urine, sudden movements, or on the least lascivious 
excitement. 

It may occur at night when dreaming, or frequently 
towards morning; when lying on the back, or sleeping 
on the sofa. When the semen escapes with the urine 
during micturition, without erection, and the patient is 
unaware of the circumstance, the most disastrous con- 
sequences are likely to ensue ; and it is by far the most 
dangerous form of the complaint. It results generally 
from sexual excesses, and particularly from long-con- 
tinued masturbation; but it may likewise arise from 
chronic gonorrhoea, the use of irritating injections, strict- 
ure of the urethra, morbid conditions of the rectum in- 
ducing straining at stool, excessive abstemiousness from 
connection, diseases of the cerebellum and spinal marrow, 
excessive length of the prepuce causing an inflammation 
of the surface of the glans, the use of aphrodisiacs, intes- 
tinal worms, &c. Nocturnal emissions are at first accom- 
panied with lascivious dreams, erections, and pleasurable 
sensations; but as the disease advances the sensations 
disappear, and the loss is only revealed by the moisture 
or stains on the linen. "[Infrequent at first, they occur 
in time two or three times a week, and latterly every 
night, and even several times in the night. Gradually 
the semen loses its consistence, the spermatozoa diminish 
in number, and it becomes reduced to a thin, pellucid 

135 



136 NON-SYPHILITIC DISEASES. 

mucus, occasionally mixed with blood. When the dis- 
ease has reached this stage the most trivial cause induces 
a loss of semen. 

In the daytime it generally occurs during micturition or 
at stool, without erection, and by the simple mechanical 
pressure on the organ. During an emission of urine the 
loss of semen takes place only when the last drop is about 
to be discharged. These last drops are thicker, viscous, 
ropy, adhere to the orifice of the urethra, and stain the 
linen. If the urine is collected in a glass, it becomes tur- 
bid, and at the bottom of the vessel are small, rounded, 
transparent, granular bodies. When spermatorrhoea is 
complicated with spinal irritation, the urine deposits in 
the morning a copious light-brown sediment ; it reacts 
like an acid, has a sickly odor, and throws up to its sur- 
face a fine, opalescent, greasy pellicle, which, after re- 
moval, is invariably reproduced. One of. the unavoidable 
consequences of the disease is impotence ; the quality and 
consistence of the semen becoming altered, and the sper- 
matozoa either disappear, or become so weak that they 
lose all fecundating power. 

The continued loss of semen gradually diminishes, and 
finally destroys, the power of digesting food, the patient 
complains of weight in the stomach, distress, restlessness, 
fetid eructations, colicky pains, irregular stools, and cos- 
tiveness alternating with diarrhoea, till at last constipation 
becomes permanent, and keeps up the loss of semen ; the 
pulse also becomes irregular, and there is a tendency to 
cerebral congestion. He loses flesh, is sensitive to the 
cold, his complexion is sallow, with blue circles round the 
eyes ; his voice grows thinner, the speech timid, there is 
great taciturnity, and the whole activity is impaired. As 



NON-SYPHILITIC DISEASES. 137 

the emaciation increases, the skin becomes pale-yellow, 
the eves are deeply sunken, the muscular energies sink, 
and the least exertion produces weariness. 

The nervous system is also particularly affected ; the 
visual power is weakened, the pupil dilates, short-sighted- 
ness and double vision set in, black or shining spots hover 
before the eyes, there is great intolerance of light, and 
even blindness may supervene ; the hearing is also affected, 
the taste impaired, and the tongue thickly coated. Pa- 
tients suffering from spermatorrhoea become languid, 
effeminate, pusillanimous, the power of volition is weak- 
ened, and even destroyed ; they are diffident, sensitive, 
capricious, irascible, low-spirited, melancholic, and averse 
to any kind of work. 

In order to ascertain the existence of spermatorrhoea, 
and not mistake it for the symptoms of some other affec- 
tion, many phenomena may lead to the recognition of 
the disease. The stains on the linen are proofs of the 
seminal losses ; but when, in consequence of the long con- 
tinuance of the disease, the semen becomes thin and 
watery, or is mixed with urine, it is more difficult to 
arrive at a certainty as to the nature of the discharge. 
In such cases the urine ought to be filtered, and then it 
will be found that the globular flocks of the semen and 
the spermatozoa remain behind on the filter ; but should 
the alteration of the semen be considerably advanced, 
the globular flocks disappear, and the spermatozoa fall 
to the bottom of the vessel, where they may be easily 
viewed with the microscope ; otherwise the formation of 
crystals of oxalate of lime may be a sufficient diagnosis. 
The microscope supplies valuable indications concerning 
the quality and numerical increase or decrease of the 
12* 



138 NON-SYPHILITIC DISEASES. 

spermatozoa. If the disease is in an advanced stage, the 
spermatozoa diminish in number, are imperfectly de- 
veloped, move but very slowly, or are quite motionless. 
Should marasmus (rapid emaciation) set in, they entirely 
disappear, and in their places are seen shining, roundish 
little bodies, devoid of all fecundating powers. As soon 
as improvement in the condition of the patient takes 
place, the spermatozoa reappear in the semen. 

Treatment. — Besides strict diet and regimen, the 
firmest resolution on the part of the patient to abandon 
the practice which may have been the source of the 
disease, and to follow implicitly the advice of his medical 
friend, are imperative. If possible, both bladder and 
rectum should be emptied before retiring to bed, which 
should not be too soft, and the patient should rise early, 
and lie on his side in preference to his back. In the day- 
time, body and mind should be occupied in a useful 
manner, and exercise in the open air is advantageous, 
even in the severer forms of the disease. 

[This disorder, like the tendency to masturbation (its 
principal immediate cause), may be regarded as inti- 
mately connected with a psoric constitution. Some per- 
sons incline very much this way ; and others not. A 
careful study of the family constitution of those who do 
thus suffer, will show the truth of the above remark, 
which Hahnemann himself first made, in the Organon. 
The reason for re-stating it here is this : in the absence 
of any specific remedy for spermatorrhoea, (see Jahr's 
Repertory in loco,) the physician must study the 
constitutional symptoms of his patient, and even of 
his patient's family. From this point of view, it will 



NON-SYPHILITIC DISEASES. 139 

be seen that the principal remedy for spermatorrhoea, as 
also for disposition to masturbation, has been omitted by 
Berjeau. This is sulphur. The higher preparations of 
this powerful antipsoric — so suited to the most common 
characteristics of such persons — will, if not actually effect 
a complete cure, at least greatly facilitate, and render 
possible such a cure by some other medicine. 

In some constitutions a single cup of tea, either black 
or green, at supper will surely cause an emission in the 
course of the night. The use of cold water to the parts on 
going to bed tends to strengthen them, and thus enable the 
organs to hold their precious contents. Cold bathing in 
the open air, when practicable, is a most important aid to 
the treatment of such cases. Let the patient be encour- 
aged and cheered by his physician in every possible way.] 

[Allium cepa, which is homoeopathic to this complaint, 
I have used with success.] 

[Gelseminum is another still more important remedy. 
See Raue, in loco.~\ 

Capsicum. Repugnance to movement; great sensi- 
bility to fresh air ; sleeplessness without apparent cause ; 
impotence, atrophy, and coldness of the genitals ; violent 
erections in the morning ; trembling of the whole body 
during venereal excitement. 

Carbo veg. is useful when the disease is accompanied 
with constipation and heartburn, acidity of the stomach, 
and flatulence, distress after eating, and distention of the 
bowels. 

Causticum is required when the urine contains stringy 
mucus, with sensation of burning in passing water, or 
when blood is also passed, the pollutions being very fre- 
quent, with continual loss of prostatic fluid ; it is very 



140 NON-SYPHILITIC DISEASES. 

efficacious when the memory is very deficient, or the head 
appears confused. 

Cinchona is very important when the disease has 
weakened the patient considerably, the least exercise pro- 
ducing great fatigue, and he is troubled with a ravenous 
craving for food. 

Graphite can be given when the emission is almost 
involuntary, without erection, or when there is tension 
and cramp-like pain in the genital organs. 

Nux vomica is of importance where there is great 
costiveness and bad taste in the mouth, with soreness of 
the stomach, accompanied with pain after eating, and 
fulness at the pit of the stomach, and also when there is 
great irritability and feeling of lassitude and fatigue. 

Mercurius should be given when the tongue is thinly 
coated, the taste depraved, complexion sallow, with 
chilliness and great sensitiveness to cold ; also when 
there is costiveness, the motions consisting of hard balls 
or lumps, having a dark color. 

Phosphorus is of great value when the nervous system 
seems shattered and the patient complains of oppression 
and pains in the chest, with tendency to cough. 

Acid Phosph. This remedy is of special value in 
many cases, particularly when there is great feeling of 
weakness of the genitals, the semen being lost on the 
least provocation ; for the debility which ensues from the 
long continuance of the complaint it is invaluable. 

MASTURBATION, Onanism, or Self- Abuse. — This 

vice, the pernicious effects of which on the system have 
been so powerfully described by Tissot, that his book has 
been said to "have brought many sufferers to despair, 
instead of curing them," is the source of a great many 



NON-SYPHILITIC DISEASES. 141 

diseases, destroying the body, and at the same time the 
mental faculties of those addicted to it. Children, after 
having indulged in this practice for a time, without 
being otherwise sick, lose their bright complexion, which 
becomes pale, with a greenish tint, especially around the 
eyes, which are sunken, surrounded by blue margins ; 
their minds are indolent, they sit with the head inclined 
forward, staring as if absorbed in deep thought, are 
averse to play, prefer to sit quiet and alone, become ob- 
stinate, peevish, and irritable, and cannot bear the least 
joke. Gradually every function, especially digestion, 
suffers more or less, the tongue and teeth are coated, 
the body becomes emaciated, and the mental faculties 
weakened. Should some kind of sickness attack them, 
it is generally severe, and the least fever is apt to assume 
a typhoid form. If this vicious habit is continued beyond 
the age of puberty, the mind is weakened, the memory 
impaired, if not lost, the ideas become confused, and the 
patients are frequently seized with mania : the body is 
exhausted, its growth checked; violent pains, such as 
headaches, pressure at the stomach, colic, nausea, and 
vomiting, or pains in the chest, with indescribable lassi- 
tude of the limbs, torment the unhappy sufferer; the 
face is covered with itching pimples, or pustules, on the 
nose, chest, and thighs; some lose all power of erection, 
others lose their semen at the least excitement, or are 
troubled with spermatorrhoea, whilst many either lose 
their urine involuntarily, or, on the contrary, suffer from 
retention of urine. 

In women, however, the consequences of self-abuse are 
not less troublesome than in men. Nervous prostration 
is the first effect produced in young females, and is cha- 
racterized by headache, depression of spirits, obstinacy, 



142 NON-SYPHILITIC DISEASES. 

sadness, indifference to worldly pleasures, and, finally, 
melancholy, or other forms of mental derangement. The 
senses become duller, especially the eyes, which are red 
and dim, with a staring look; all sorts of spasmodic 
symptoms, such as hysteria, palpitation of the heart, 
chorea, epilepsy, catalepsy, convulsions, are the conse- 
quences of this nervous irritation. The face looks sallow 
and thin, the skin is rough and dry, cracked, covered 
with pimples ; the lips are pale, and the teeth decay ; a 
copious mucous discharge takes place from the vagina, 
excoriating the thighs, groins, and perinaeum ; the inter- 
nal organs become diseased, and induration and cancer 
of the womb may be the final results of this pernicious 
practice. 

Treatment. — The ill consequences of self-abuse may 
be prevented or removed by the timely and appropriate 
administration of remedies (homoeopathic) to the patho- 
logical signs presented, and by acting morally on the 
mind of the patient. 

The most efficacious remedy in obliterating a tendency 
to this vice is Sulphur, a dose of which may be given, 
followed, in a week or so, by Calcarea. 

Nux Vomica is of very great importance where the 
digestive organs are impaired, attacks of uneasiness, 
principally after dinner, with nausea and trembling of 
the limbs, emaciation of the body, frequent erections and 
pollutions, principally in the morning, with flaccidity of 
the penis, followed by coldness and weakness in the 
lower extremities, and increased sexual desire, occur. 
[It should be taken on going to bed ; and is especially 
indicated when high living, coffee, spirits, &c, have 
promoted the difficulty.] 

Staphysagria is perhaps the most efficacious remedy 



NON-SYPHILITIC DISEASES. 143 

in this complaint, particularly in cases of long standing, 
and may be employed when there is hypochondria with 
great taciturnity, constant uneasiness as to the state of 
one's health, anxious imagination, imaginary fears, queer 
notions that expose the patient to the suspicion of being 
thought crazy, great deficiency of animal heat, and ten- 
dency to take cold ; or when the memory is weak and 
confused, and there is giddiness and sleepiness ; the eyes 
are deep-sunken, red, and lustreless, the hair falls off, 
there is gnawing toothache and caries of the teeth, which 
are very brittle, a dry cough, aggravated frequently 
after eatiug, and indigestion attended with great flatu- 
lence, the stools being dry and lumpy. The urine is of 
a deep red or yellow color, with brick-dust sediment ; 
there is continual loss of prostatic fluid, and the sexual 
desire is impaired and the penis relaxed, with dull and 
contusive pain in the testicles. Nux Yom., Calc. c, or 
Cocculus are frequently required after this remedy. 

[With Berjeau's opinion of the superior efficacy of 
Staph., in this complaint, I heartily coincide. While 
preparing these pages for the printer, a young man, to 
whom I had given this remedy, reported himself cured. 
He was also very much improved in physical appearance 
and that of feeling. A weakness of his chest, and tight- 
ness and sense of compression, with which he was apt to 
be troubled, w^hen not suffering from emissions, were per- 
manently removed by a single dose of sulphur 55 thou- 
sand. The intimate connection of this complaint with 
consumptive persons and families, and its almost inevi- 
table tendency to extend to phthisis pulmonalis, but 
confirms its psoric nature, as asserted in my remarks on 
Spermatorrhoea.] 



144 NON-SYPHILITIC DISEASES. 

Cinchona. When the patient has practised this vice 
to excess, or for many days in succession, this remedy 
will speedily relieve the weakness and lassitude which 
have been produced. It is more especially indicated when 
there is dulness and confusion of the head, with indiffer- 
ence to everything, the spirits being low, and attended 
with anxiety; the sleep very bad, the appetite poor, 
sensation of fulness and oppression at the stomach, with 
great flatulence ; the stools loose, of a white color, con- 
sisting principally of undigested food, the skin being 
cold, with a febrile, small, soft, frequent pulse. 

Kreasote. In chronic cases, with tendency to scrofu- 
lous degeneration, this medicine is very useful; it can 
be given when there is bleeding of the nose, swollen and 
bleeding gums, and toothache, foul breath, and loss of 
appetite, with cutting, colicky pains, and diarrhoea of a 
fetid kind; general lassitude, yawning T drowsiness, and 
coldness of the skin, with eruption of pimples of a bright 
red color, are also good indications for its employment. 

Carbo veg. is very efficacious in subduing an excessive 
excitement of the sexual organs, with lascivious fancies 
and onanism; and particularly when there is present 
greenish acrid leucorrhcea in females, often the cause or 
effect of self-abuse ; it can be given when the patient is 
irritable and ill-tempered, with constant restlessness and 
great prostration; or for shuddering and great sensi- 
bility to cold, with deranged stomach, excessive flatu- 
lence, and frequent emissions of semen (spermatorrhoea). 

Phosphorus. This remedy is of good service when 
the patient is very debilitated, and is subject to affections 
of the chest; it may be employed where the head is 
affected, the memory being weak or almost gone, with 



NON-SYPHILITIC DISEASES. 14.5 

pulsations in the brain and various parts of the body, the 
eyes being red and sunken, the sight and hearing im- 
paired, the appetite either bad or extremely ravenous, 
with nausea and drowsiness after eating, diarrhoea of a 
painless kind being often present ; or frequent pains in 
the chest, attended sometimes with cough and palpitation 
of the heart. It is also very useful in milky leucorrhcea 
in females, attended with bearing-down pains. 

Calc. carb. is required when there is great depression 
of spirits, excessive sensitiveness, fatigue produced by 
the least exertion, and a general sense of illness and de- 
rangement of the various animal functions ; the head is 
dizzy, and headache is produced by the least mental ex- 
ercise, thinking being difficult ; the hair comes off, the 
eyes are suffused, pus is discharged from the ears, and 
there is difficulty of hearing, the nose bleeds, the face is 
covered with itching pimples, a foul taste is in the mouth ; 
there is loss of appetite, with constant thirst, constipa- 
tion, and hard and scanty stools, sometimes as white as 
clay, with great flatulence, frequent emission of milky 
urine, deficiency of sexual desire, premature and profuse 
menses, often attended with acrid leucorrhcea, swelling 
of the feet, great sensitiveness to cold, and followed 
sometimes by cough and profuse expectoration and 
violent palpitation of the heart. 

Cocculus. This remedy can be employed when the 
head is more particularly affected, and there is sadness, 
irascibility, anxiety, restlessness, particularly at night, 
headache, affecting the forehead, and often a feeling of 
intoxication, and very frequently imaginary fears. 

Pulsatilla is very often required, especially for females, 

when the practice has brought on leucorrhcea or hysterical 
13 



146 NON-SYPHILITIC DISEASES. 

affections. The leucorrhoea is generally milky and pain- 
less, attended with pains in the back; the menses are 
generally profuse, of a dark or blackish color, and there 
are spasmodic pains in the lower abdomen, with great 
sexual excitement, and pains resembling labor-pains. 

Antimon. cruel, is useful when the digestive faculties 
have become impaired, with eructations and vomiting of 
food, attended with colic and flatulency, and diarrhoea 
alternating with constipation ; a constant sensation being 
present, as if the stomach were overloaded, the appetite 
totally failing ; sadness, weeping, and impressibility often 
accompany these symptoms. 

SPINAL IRRITATION. — Pain or soreness of the 
spine frequently accompanies diseases of the urinary and 
sexual organs, and is generally felt in the lumbar and 
sacral regions ; it may arise from hysteria, sexual ex- 
cesses, masturbation, leucorrhoea, cancer of the uterus, 
gonorrhoea, and various urinary diseases. The symptoms 
are aggravated by disagreeable emotions, luxurious living, 
stimulating drinks, menstrual derangements, late rising, 
and sleeping on the ground. The strictest investigation 
is necessary as to the probable cause of the complaint, 
as the treatment is necessarily dependent upon a right 
appreciation of certain circumstances. It is important 
to enforce strict dietary rules, abstaining from meat, 
coffee, tea, or spirituous liquors; perfect abstinence from 
all sexual excitement; gentle exercise in the open air, 
early rising, walking, and sea-bathing, are very useful 
and restorative. 

Arsenic is very useful in debilitated subjects, who 
complain of acute drawing pains in the back, which ne- 
cessitate lying down. 



NON-SYPHILITIC DISEASES. 147 

Belladonna can be given for dull distressing pains, 
drawing round the whole pelvis, or for intense cramp- 
like pain in the small of the back and sacrum, relieved 
by standing or walking, and when there are nocturnal 
emissions without erection. 

Calc. carb. is of great service when there is great 
weakness of the back and nervousness, with excessive 
sexual desire, in persons addicted to self-abuse. 

Chamomilla is efficacious in cases of drawing or great 
bearing down, with pressing pain in the small of the 
back and down the thighs, and coupled with sexual ex- 
citement and itching of the scrotum. 

Causticum. Xervous weakness and pains in the 
loins, rendering the least movement intolerable, and 
painful stiffness of the parts. 

Cocculus is good in tremors affecting the back, which 
feels bruised, with increased sexual desire. 

Conium can be employed when there are spasms or 
stitches in the small of the back, with drawing in the 
lumbar region when standing ; the sexual desire is lost, 
and emission of semen takes place on the least excite- 
ment. 

Lycopodium is required for violent pain in the back, 
with stiffness of the parts, chilliness, and shrinking and 
coldness of the penis. 

Nux Vomica is one of the most efficacious of the reme- 
dies employed against this complaint arising from sexual 
excesses. The pains are principally felt at night in the 
small of the back, with sore and bruised feeling in the 
lumbar region when pressed; attended with sudden 
stitches in the back, on turning to one side, with dull 
pain when sitting perfectly quiet ; it is also very useful 



148 NON-SYPHILITIC DISEASES. 

in nocturnal emissions, with contused pain in the testi- 
cles, and continued painful erections. 

Pulsatilla can be used with success when there is weari- 
ness and stiffness of the back, the right testicle being 
drawn up and swollen ; continual erections day and night, 
with excited sexual desire, and seminal emissions. 

Rhus toxic, will be found useful for contusive pains 
in the back, when lying still, or sensations as if the part 
were pressed against a sharp edge ; also in tympanitic 
swelling of the scrotum, with violent sexual desire, and 
seminal pollutions. 

Sepia. When there is a tendency to chronic conges- 
tion of the vessels of the spine, occasioning great in- 
crease of sexual desire, with painful and violent erections, 
and great weakness in the small of the back. 

[CEREBROSPINAL MENINGITIS.— Although this 
formidable disease is not known to be anywhere prevalent 
at this time, some account of its most common forms and 
prominent symptoms may neither be unacceptable for 
present study, nor without value for future use. And we 
are the rather led to undertake the work from the fact, 
that, while Epidemic "Spotted Fever" may at any time 
make its appearance, and in any section of the country, 
very little can be found recorded hitherto, in the periodi- 
cal or other literature of our school, concerning its pa- 
thology or its therapeutics.* 

* Marcy and Hunt (" Theory and Practice " Vol. I. p. 527) give 
a brief account of this disorder, with no other aid — besides men- 
tioning a few remedies — as to " treatment" than : " this must be 
conducted on the same general principles as we are governed by 
in congestive intermittents." This advice is meagre enough in 



NON-SYPHILITIC DISEASES. 149 

The base of the brain becomes the seat of two distinct 
forms of meningeal disease ; these have been designated 
as simple meningitis, and as tubercular meningitis. In 
the former, the pia mater, and sometimes the arachnoid 
of the convexity of the ventricles, are inflamed — often to 
very considerable extent — and infiltrated with pseudo- 
membranous and purulent liquid deposits. The latter, 
— characterized by tuberculous granulations deposited in 
the meshes of the pia mater, accompanied by ventricular 
effusion, by cerebral tubercles, and often by tuberculous 
deposits in some other organ — is usually called acute 
hydrocephalus. 

True, tubercular meningitis can only be developed, of 
course, in persons under the influence of the tuberculous 
diathesis ; that is, in tuberculous (scrofulous) subjects. 
While simple meningitis, so far from being restricted to 
those who are not of a scrofulous or psoric constitution, 
is certainly more apt to be developed in those who are. 

" These differences," says M. Rilliet, " which M. Bar- 

itself, but the assertion which precedes, that "the pathological 
features of the disease cannot be distinguished from those of con- 
gestive intermittent," is still worse, because more misleading. 
Here again we find repeated the great error of the allopathic 
school, — the very one of all others which a work on homoeopathic 
practice should have eschewed ; a conjectural therapeia, based 
upon a supposititious pathological trestle-work. Not only do our 
authors furnish no indications for the remedies, but their " treat- 
ment" rests upon a pathology which is at once hypothetical and 
unsound. 

Raue (" Pathology and Therapeutics," p. 13) gives a concise 
statement of the principal symptoms, and "therapeutic hints " for 
a few remedies, of which we have made use in the latter portion 
of this article, 
13* 



150 NON-SYPHILITIC DISEASES. 

thez and myself have already expressed in detail, are so 
decided, that, if we are shown the brain of a child in 
which the fissure of Sylvius is agglutinated, and pseudo- 
membranous, or concrete purulent infiltration exists at 
the base, whilst the arachnoid and the pia mater of the 
convexity are uninflamed, we do not hesitate to affirm, 
on this simple examination, and without further micro- 
scopic investigation, that most probably there are granu- 
lations in the meninges, that the ventricles are, or have 
been distended by serous effusion, and that there cer- 
tainly exist tubercular deposits either in the lungs or 
bronchial glands, or elsewhere. We could affirm that 
the acute symptoms have been preceded by prodromata, 
that the outbreak was insidious, that the meningitis was 
announced by vomiting, constipation, and moderate ceph- 
alalgia, without acute fever ; that the intelligence was 
intact, at any rate during the first week, and that the 
disorder lasted from fourteen to twenty-one days. On 
the other hand, on being shown the brain of a child, 
where the convexities of the hemispheres are covered 
with purulent deposits or false arachnoidian membranes 
to considerable extent, we do not hesitate to affirm, with- 
out fear of being contradicted by experience, that no 
tuberculous deposit is to be found either in the meninges, 
brain, or elsewhere ; that the outbreak was abrupt and 
violent, introduced by convulsion, if the patient was 
very young, by vomiting, constipation, and violent head- 
ache, if the child was older. That the symptoms were 
followed, after from one to three days, by formidable 
phrenesis, and that the course of the whole malady was 
very short, viz., three, four, or six days."* 

* Traits Clinique et Pratique; par M. M. Rilliet et Barthez. 
Paris, 1846. 



NON-SYPHILITIC DISEASES. 151 

This description — written in France nearly twenty 
years before the appearance of the epidemic cerebro- 
spinal meningitis in this country — so closely resembles 
our " spotted fever," that it seems to prove this strange 
and malignant disorder to be but a development of 
''simple meningitis." But the distinction so much dwelt 
upon by our authority, and which admits of demonstration 
only upon the dead subject, would scarcely be deemed 
of any practical importance, were it not possible to indi- 
cate some peculiarity by means of which it may be rec- 
ognized in the still living patient. This peculiarity we 
think may be found in the pseudo-membranous nature 
of the deposit already described as occurring at the con- 
vexities of the hemispheres. or ventricles, and which no 
doubt extends downwards along the course of the spinal 
meninges. But this false membrane, which is obvious 
enough upon examining fatal cases of " simple meningi- 
tis," — and we believe no less so in those of the modern 
epidemic " cerebro-spinal meningitis,"* — can itself be 

* "Four cases are related of the disease with the post-mortem 
appearances. In all the cases, deposits of lymph, of greater or 
less extent, were found on the brain and spinal cord. In one 
case, the anterior two-thirds of the cerebrum superiorly, was 
covered with an adventitious deposit of lymph, of a greenish 
yellow color, forming adhesions between the arachnoid and the pia 
mater, and following the latter as it dips down into the convolutions 
of the brain. In another case, there was a deposit of lymph be- 
tween the pia mater and arachnoid, on the anterior surface of the 
cerebrum superiorly, extensively upon and around the optic 
commissure, over the entire cerebellum, crura cerebri, pons 
Varolii, medulla oblongata, and spinal cord throughout its whole 
extent to the cauda equina. The nerves arising from the cord on 
both sides were enveloped with this deposit also. At several 



152 NON-SYPHILITIC DISEASES. 

recognized during life only by some other and constantly 
attendant symptom. This constant and pathognomonic 
symptom may be found, we believe, in the " spots," 
from which arises the popular name of the disorder. 
For here, as in many other forms of disease, the conse- 
quences, which are seen, take precedence, in naming the 
disease, of its causes and essential nature, which may be 
alike unknown. We speak of these " spots " as being 
constant ; but in the milder cases they may not be dis- 
cernible, and the severest cases may prove fatal before 
they are developed, — as children sometimes succumb to 
malignant scarlatina before the eruption is developed. 

From the constancy of the appearance of "spots," pe- 
techia, ecchymosis, &c, in the lowest form of typhoid 
fever, in jail and ship fevers, in diphtheria, in croupous 
diphtheria, and in epidemic cerebro-spinal meningitis, or 
" spotted fever," we learn that these " spots " result from 
a certain suppression of the capillary circulation and 
dyscrasia of the blood itself, which indicate a profound 
prostration of the vital forces. And we may with safety 
conclude that this same blood disease and accompanying 
nervous prostration, which cause these " dark purplish 
spots," produce also those plastic exudations, which are 
known as pseudo-membranous formations, or false mem- 
branes. Hence the most remarkable pathological differ- 
ence between the two forms of disease — diphtheria and 
spotted fever- — which have all along been regarded as 
mysteriously similar, will actually illustrate and confirm 

points along the cord it had degenerated into pus." This 
' ' lymph " upon interior surfaces corresponds to the denser false 
membranes organized from plastic exudations upon exterior, 
mucous surfaces. 



NON-SYPHILITIC DISEASES. 153 

this very similarity. For, in diphtheria, the blood-dys- 
crasia gives rise to plastic exudations, or false membranes, 
on free mucous surfaces ; while in epidemic cerebro-spinal 
meningitis the pseudo-membranous deposit occurs on the 
convexity of the ventricles, or hemispheres, — that is, on 
enclosed and confined surfaces. And, in consequence, we 
find, in the former disease, final paralysis from nervous 
prostration, but no previous spasm from compression; 
while, in the latter disorder, convulsions from nervous 
compression precede paralysis from exhaustion. 

Dr. Kempf, an intelligent physician of Southern In- 
diana, gives an account of the epidemic as it occurred in 
his section, in the month of December, 1862.* He 
makes three divisions of the disease, according to its 
intensity: cerebro-spinal asphyxia, — corresponding to 
the worse forms of cholera, or yellow fever, in which 
there is no reaction; cerebro-spinal inflammation, the 
fully developed cerebro-spinal meningitis; and cerebro- 
spinal irritation, in which the attack of the disease is 
comparatively slight. We give his description of each 
form ; his whole account, although it may not exactly 
resemble the epidemic anywhere else, will enable the 
physician to recognize the disorder the first time he 
meets with it. 

" Cerebro-spinal asphyxia is generally ushered in with 
an alternation of chilliness and heat, violent pain in the 
head and back, pain in the extremities, vomiting, and 
diarrhoea of a bilious character. The patient presents an 
appearance as though he was deeply intoxicated. When 
roused, he will give a half intelligent look and an inco- 
herent answer. His eyes are dull, injected, watery, and 

* Am. Jour. Med. Sci., No. CIII. New Series, p. 55. 



154 NON-SYPHILITIC DISEASES. 

the pupils dilated, or one contracted and the other dilated ; 
the pupil may be round, elliptical, or irregular. Tongue 
cool and swollen ; breath cool. Pulse irregular, feeble, 
and frequent; though sometimes it is almost natural, 
calm, regular, soft and full, whenever the patient is sink- 
ing rapidly and the approach of death is imminent. The 
surface of the patient is mottled with purplish spots. 
Cramps of the extremities are common ; sometimes there 
is jactitation of the whole body, but not of the violent 
character observed in cerebro-spinal inflammation. 

" Cerebrospinal meningitis, the sthenic type of the 
disease, with evidence of inflammation of the meninges 
of the brain and spinal cord, generally commences with 
a peculiar nervous agitation, wandering pains of a rheu- 
matic or neuralgic character, followed by a chill and by 
inflammatory reaction ; pain in the head, darting from 
temple to temple ; pain along the spine^ and in the ex- 
tremities, much aggravated by movement or pressure ; 
acute sensibility of the surface, the least pressure or the 
slightest touch causing the patient to moan or scream ; 
high vascular excitement. As the disease advances, the 
patient becomes more or less delirious, his countenance 
having a wild expression. He is often affected with 
cramps of the extremities, tetanic spasm or hysteric con- 
vulsions. The eyes are injected, and intolerant of light ; 
the pupils are generally contracted, though sometimes 
one is dilated and the other contracted, the edge of the 
pupil being round, oval or notched ; the pupil itself is 
either clear or opaque, with a milky or greenish effusion 
— this is generally, however, a symptom of the latter 
stage of the disease ; there is defective vision, muscse 
volitantes, or complete amaurosis. The sense of hearing 



NON-SYPHILITIC DISEASES. 155 

is sometimes very acute, again very obtuse, or totally 
lost. The stomach is generally irritable, with more or 
less vomiting of a bilious character. The bowels are 
mostly costive. Urine high-colored and scanty. In 
most of these cases, herpetic eruptions appear about the 
mouth and nose. A prominent symptom, which has 
been considered by some writers as pathognomonic, is 
generally present, namely, spots or petechiae of a scarlet 
color, generally minute in size and few in number, though 
in some instances they cover the greater portion of the 
surface of the body. In the malignant type, the skin 
presented a maculated appearance, of a dull crimson, or 
deep purple hue. 

"The duration of cerebro-spinal meningitis is from 
twenty-four hours to two or six days ; the majority die 
between the latter periods, but now and then a case is 
protracted for several weeks or months. The patient, 
after becoming convalescent from an acute attack, and, to 
all appearance, out of danger, may have a slight exacer- 
bation towards evening, slight pain in the head, cloudi- 
ness of intellect, and indistinct articulation. He may 
complain of dimness of vision, anomalous sights, or one 
eye may be perfect and the other nearly blind. He may 
have buzzing in the ears, hear unusual sounds, or the 
organ may be too sensitive or too obtuse. I have visited 
patients in whom the analogy between intermittent fever 
and the disease under consideration was so perfect that 
the most circumspect would be deceived. 

" Of cerebrospinal irritation, I will only remark that, 
on the decline of the epidemic, a great number of indi- 
viduals, especially adults, complained of headache, ma- 
laise, neuralgic pains in various parts of the body, and 



156 NON-SYPHILITIC DISEASES. 

pain in the nape of the neck, or other parts of the spine. 
The ailment yielded readily to morphia and quinia. Ce- 
rebrospinal irritation very likely was a precursor to the 
graver forms ; but as not much alarm was felt before the 
epidemic had made some ravages, the physician was not 
consulted in this minor form of the epidemic." 

Dr. Kempf narrates five cases of the severest, or, as he 
would term it, the asphyxia form of the disease ; all of 
which proved fatal within six or seven hours at the 
furthest. The second case we quote : " H. B., a fine 
boy, of seven years of age, left home at 8 a. m., to at- 
tend school, half a mile distant; he returned at ten 
o'clock, complaining of violent pain in the head. As the 
child had been subject to ague, the parents attributed his 
symptoms to an attack of that disease ; but as he soon 
became insensible, and his surface covered with purplish 
spots, I was requested to see him at 2 ft m. I found the 
child comatose ; insensible to shaking or pinching of the 
extremities ; to all appearance blind and deaf ; eyes in- 
jected and turned upwards, pupils dilated ; pulse per- 
fectly natural. This condition was found to be in every 
instance a very unfavorable symptom. Death occurred 
the same evening." 

The following description of the same disorder as it 
appeared in Mobile, Ala., during the winters of 1863-4, 
and 1864-5, will be found interesting and instructive.* 

"In the midst of good health, after taking a hearty 
meal, or after a full day's work, the patient, without any 
premonitory symptoms, is suddenly attacked with coma, 
or stupor, so profound that he is with difficulty aroused 
even for a moment. 

* Atlanta Med. and Surg. Jour., June, 1866. 



NON-SYPHILITIC DISEASES. 157 

" In other cases, vertigo, pain in the head and cervical 
region, extending along the spine, with lassitude and ap- 
prehension of impending danger, are observed. Then 
again, chilly sensations at intervals of two or three hours, 
with cold extremities, followed by exacerbation of heat, 
flushed face and increased pulse, mark the approach of 
the disorder. Lastly, delirium, more or less w^ild, with a 
disposition forcibly to leave the bed or room, is in the 
outset a prominent symptom. The condition of the pulse 
was variable ; usually ranging from ninety to one hun- 
dred, hardly reaching one hundred and ten, unless just 
before the termination in death ; on the other hand, it 
occasionally sank to forty or fifty beats per minute. 
Vomiting of bile and constipation are usually, in the be- 
ginning, prominent symptoms ; the tongue is furred, and 
as the disorder advances, the teeth become covered with 
sordes. 

" The urine is highly colored, scanty and often re- 
tained ; at other times, especially towards the close, it is 
passed involuntarily. Intolerance of light and sounds, 
when present, appears at the early part of the attack ; 
the least ray of light being sufficient to cause spasmodic 
closure of the eyes and intense suffering ; walking across 
the floor is excessively annoying to the sufferer ; deafness 
and a general indifference to surrounding objects are 
m generally noticed. 

" The most prominent and almost universal symptoms 
are pain in the head and neck, accompanied by a tetanic 
rigidity of the cervical muscles, and of the large extensor 
muscles of the back. This trouble, slight at first, in- 
creases until the head is drawn back upon the shoulders, 
and no ordinary degree of force used by the attendant 
14 



158 NON-SYPHILITIC DISEASES. 

can overcome it. The muscles of the back and lower 
extremities are occasionally so much involved as to pro- 
duce complete opisthotonos. In connection with this 
condition, paralysis of the muscles of the face is some- 
times present, as exhibited in depression of the lower 
jaw and protrusion of the cheeks and lips in expiration. 
Involuntary twitchings of the muscles and want of pre- 
hension often exist also— the patient being unable to 
drink without assistance. Strabismus in one or both 
eyes was met with in several cases. The appearance of 
the pupils is not always the same, in the majority of 
cases being dilated ; sometimes one is contracted and the 
other dilated, and I have occasionally seen both con- 
tracted. Delirium may be present at any period of 
cerebro-spinal meningitis, though most common in the 
latter stages before coma sets in ; and is then of a low, 
muttering character. 

"When coma comes on, which is usually about the 
fourth or fifth day, the pupils become widely dilated, the 
pulse more full, but is never, so far as my observation 
extends, of a bounding character, as in coma from apo- 
plexy. Involuntary discharges from the bowels and 
bladder are now of most frequent occurrence. Stertorous 
breathing is rarely present, and until coma is profound, 
the patient is continually tossing himself from side to 
side in bed, and carrying his hands to his head asthough* 
in great pain. 

" Another very common symptom is hypersesthesia 
of the whole nervous system ; pressure upon the ex- 
tremities, slight mo.ving of feet or bending the toes, 
causes the patient to cry out from pain. This exaltation 
of sensibility does not often appear at first, but towards 



NON-SYPHILITIC DISEASES. 159 

the latter part of the attack. While vertigo, pain in the 
head, chilly sensations, intolerance of light and sound, 
deafness, stupor, exalted sensibility of the nervous sys- 
tem, delirium and coma were the usual symptoms by 
which this epidemic was characterized ; yet there were 
few cases of an intermittent type, accompanied by high 
fever, with pain in the head. Under the use of quinia, 
these symptoms would yield for a few days, and conva- 
lescence seemed to be established. A recurrence of these 
symptoms would take place two or three times, when 
those more violent, as extreme pain in the head and neck, 
rigidity of the muscles, &c, would supervene and de- 
clare unmistakably the formidable nature of the disease. 

" The duration of this affection is variable ; it may de- 
stroy life in twenty-four or forty-eight hours, but from 
five to eight days is the usual time. During the winter 
of 1863-4, it proved fatal sooner than in the following 
— a few of the last cases seen having lived from ten to 
fifteen days." 

Therapeutics. — Aconitum. Chilliness; high fever; 
hot, dry skin ; great thirst ; restlessness. Dilatation 
of the pupils ; avidity for light ; desire to look at bright 
light. Hah. — Great photophobia. (S. Codex.) Contrac- 
tion of the pupils (photophobia), according to Hale, indi- 
cates Aconite in cerebral diseases : as dilatation of the 
pupil (and thirst for light) does Gelserninum.* 

It may be remarked that Aconite is thus indicated by 
its characteristic symptoms in cases which may indeed 
become developed as " Spotted Fever ; " but which — 

* Drs. Hale and Searle, — New Remedies, pp. 405, 426, — 
seem to deny that Aeon, primarily causes dilatation of the pupil ; 
but this is contrary to Hahnemann's experience in proving thia 
remedy. 



160 NON-SYPHILITIC DISEASES. 

except from the recurrence of other cases with similar 
symptoms terminating in this disease — could not be de- 
termined in advance as instances of it. And when thus 
administered, where alone its symptoms call for it, in the 
early stage of this disorder, (as also in incipient Diph- 
theria and Pneumonia,) this remedy may suffice to cure 
the patient entirely, by arresting the morbid processes 
before they have reached the stage of plastic effusion. 

Apis. Yiolent pains in the head, — aggravated by 
lying down ; relieved temporarily by pressing firmly 
with the hands. Great inclination to sleep, but inability 
to do so from extreme restlessness and nervousness. 
Sleep disturbed by oppressed respiration and disagree- 
able dreams. Rapid, painful, and spasmodic respiration, 
aggravated by lying down, (opposite to Cantharis,) and 
ameliorated by inhaling the fresh air in an upright posi- 
tion. Sensation as though he should notbe able to breathe 
again. Sudden prostration of the vital force. Burning, 
stinging pains. 

The direct pathogenesis of Apis presents neither the 
convulsions nor the " spots " which characterize cerebro- 
spinal meningitis ; but it has the violent headache, and 
all the paralytic symptoms which result from the serous 
or other exudation of the advanced stage of this disease. 
"While its acknowledged value in acute hydrocephalus, 
in arachnitis, and in the secondary or exudative stage of 
what is termed " Meningitis Basilaris of Children,"* will 
entitle it to a careful study in this connection. 

* U. S. Med. and Surg. Journal, Vol. I. p. 237; and II. pp. 31, 
129. Valuable indications for the remedies are given in this 
article, — equally applicable to Cerebro-spinal Meningitis, and to 
" Basilar Meningitis of Children." 



NON-SYPHILITIC DISEASES. 161 

The Apis seems to produce serous rather than plastic 
exudations; but when indicated by its dynamic subjec- 
tive symptoms, it will always do good. And we can 
see when the remedy is called for, during the life of our 
patients, by means of these dynamic symptoms ; while 
if we were to rely upon the demonstration of the exact 
pathological condition, (the nature of the exudation as 
serous or pseudo-membranous), we should be obliged to 
postpone prescribing till after we had made a post-mortem 
examination of the subject. 

In a very bad case of Spotted Fever in a young man — 
successfully treated by Dr. Williamson, some years ago — 
Apis (and also Cantharis) was found of great service in 
relieving the accompanying urinary difficulties. These 
nephritic complications, which are so common to both 
Spotted Fever and Diphtheria, furnish additional proof 
of the similar nature of the two disorders. 

In Spotted Fever, as in other affections of the nervous 
centres, Apis is believed to be far more efficient in the 2° 
than in any lower preparation.* 

Arnica. Red, blue, and yellow spots, like ecchymoses. 
Coma somnolentum, with delirium and carpologia. Jac- 
titation of single muscles; twitching in all the limbs; 
tremor of the limbs. Convulsions and tetanic spasms. 
Painful and excessive sensitiveness of the whole body.f 

These strongly-marked objective symptoms, and the 
great efficacy of Arnica in certain forms of Typhoid and 

* Compare Marcy and Hunt's Practice, Vol. I. p. 530 ; and 
U. S. Med. and Surg, Jour., Vol. II. p. 180. 

f "Pressure on the back of the neck elicits a cry of pain," on 
the fourth day, in a case which terminated fatally on that day. — 
Am. Jour. Med. Set., July, 1866, p. 126. 
14* 



162 NON-SYPHILITIC DISEASES. 

Typhus Fever — where the symptoms in many impor- 
tant respects resemble those of cerebro-spinal meningitis 
— should ensure the thorough study of this remedy in the 
latter disorder 

Arsenicum. This powerful drug acts primarily upon 
the organic or vegetable nervous system, and only in a 
secondary manner upon the cerebro-spinal system, al- 
though recommended with others, in a general manner, 
by Marcy and Hunt. Still, if dynamically indicated, — 
that is, by the prevailing symptoms, especially the sub- 
jective ones, — it should be carefully exhibited. And 
the success which must attend its administration will 
show the superiority of nature's great law of the Similars 
over all the deductions which we may make from our 
own petty pathological theories. 

Belladonna. Headache in paroxysms, as if the brain 
would burst, aggravated by moving the eyes, by shaking 
the head, ivhen lying down, by light and by noise ; re- 
lieved by compressing the head with the hands. Glow- 
ing redness of the face ; dark red face ; bluish red face. 
Contraction of the pupils ; dilatation of the pupils (im- 
movable pupils) ; double vision. Convulsions, especially 
of the arms. Screaming ; moaning, starts, which wake 
him even when on the point of falling asleep. Rigidity, 
with bending the body and head backwards, or to the 
left side. Right side principally affected. The peculiar 
character of the delirium and moral symptoms will de- 
termine the choice between Bell, and Stram., Hyos., and 
Yeratrum.* 

* For a full and elaborate comparison of Bell, and Stram., — 
one differing from and far superior to that of Gross, — see Wells on 
Scarlatina, Am. Mom. Review, Vol. V., March, 1865. 



NON-SYPHILITIC DISEASES. 163 

Bryonia. Sharp, lancinating pains in the head, worse 
from motion, better when lying down. Bursting head- 
ache, worse when rising up. Face red and bloated, like 
Bellad. ; but neither dilatation nor contraction of the 
pupils. Petechia?. Stiffness in the neck ; great pain in 
the limbs and joints, not allowing of motion. Plastic 
exudations, or pseudo-membranous formations;* these, 
in accordance with our view of the nature of cerebro- 
spinal meningitis, may be deposited about the base of 
the brain. And as in Diphtheria and in Croup, so in this 
disease, Bryonia, instead of being entirely overlooked, 
should be most carefully studied. 

Cantharis. Affections principally of the right side. 
Violent pains in the head ; drawing, tearing in the head; 
stitches in the head, in the occiput, as if in the bone, or 
deep in the brain, — in the right temple, — in the fore- 
head; lancinations in the head, waking him from sleep. 
Protruded eyes ; eyes in spasmodic motion; fiery, spark- 
ling, with steady, staring look; things look yellow. 
Bloatedness in the face. Lock-jaw, with grinding of the 
teeth, and discharge of foamy and even bloody saliva. 
Oppression of breathing, relieved in a recumbent position ; 
(opposite to Apis.) Retention of urine ; suppression of 
urine ; strangury ; dysuria ; paralysis of the neck of the 
bladder. 

The remarkable efficacy of this medicine in Diphtheria; 
in removing the false membranes from the fauces, and 
also from the vaginal, uterine and urethral mucous sur- 
faces ; and its value in the urinary complications of 
Spotted Fever, in conjunction with Apis, — according to 
the experience of Dr. Williamson, — strongly confirm our 
* Yide Neidhard on Diphtheria, p. 118. 



164 NON-SYPHILITIC DISEASES. 

supposition of tbe plastic nature of the exudation at the 
base of the brain in the latter disease. The respective 
subjective symptoms of Cantharis or of Apis, which may 
predominate, will determine the choice of the one or the 
other of these two remedies, when nephritic or urinary 
complications arise in cerebro-spinal meningitis. And 
the improvement brought about by either, when thus 
indicated, if not equal to the entire cure of the patient, 
will at least prepare the way and enable some other 
remedy to complete the work. In healing, as in learning, 
all that is gained is doubly valuable, — for its own sake, 
and for the sake of the still further progress which it 
facilitates and secures. 

Cicuta vi. Insensibility. Stiffness of the jaws. He 
bends his head backward. Stiff, sore neck. He feels 
sore all over. 

11 The petechia," remarks Dr. Lippef — to whom we are 
indebted for the above, and other symptoms, — "are not to 
be found in the pathogenesis of Cicuta ; but cures with 
it have been reported." 

Crotalus horrid. Pain in all the limbs ; horrid head- 
ache ; red face ; delirium with open eyes ; ecchymosed 
spots everywhere ; Raue. Most of the symptoms appear 
on the right side. Compare Crotalus cascavella in 
Mure's Materia Medica. 

Elaps corallinus.* Bight side principally affected. 
Pain in cerebellum, right side ; pain in the whole spinal 
marrow. The arm and hand are swollen, bluish, covered 
with red spots ; also, the right leg and foot, Cramps in 
the calves. Cramps in the right side. Paralysis of the 
right side ; the right side is numb, as if paralyzed. The 

* Dr. B. Mure's Materia Medica, Wm. Radde, New York, 1854. 



NON-SYPHILITIC DISEASES. 165 

extremities look blue, with reddish spots. Phlyctenae 
here and there, especially on the extremities. 

Lachesis. The leftside is principally affected. Affec- 
tions of the throat, beginning at the left side, and ex- 
tending to the right, require Lachesis rather than Lycop. ; 
while those which beginning at the right side extend to 
the left, require Lycop. rather than Lachesis.* Convul- 
sions and other spasms, with violent shriek, particularly 
about midnight, waking the patient. Aggravation of 
the symptoms during rest ; amelioration during motion ; 
exacerbation after every sleep, in the day or night. 

Each one of these several varieties of the serpent- 
poison seems capable of developing upon the skin colors 
resembling those of the serpent from which it is derived. 
" The skin (of the prover) looks like that of the snake." 
Observe the contrast : Elaps and Crotalus hor. for the 
right side ; Lachesis for the left. 

Gelseminum. Headache; heaviness, giddiness, as if 
intoxicated. Headache, which comes on suddenly, with 
dimness of sight, or double vision, and dizziness. Dila- 
tation of pupils (compare Aconite) ; complete loss of 
muscular power, of vision and speech ; icy coldness of 
the hands and feet ; nausea ; vomiting. Drowsiness ; 
wants to lie still and rest. Fever without thirst ; (thirst 
during the sweat.) Profuse emission of watery urine, 
accompanied by transient chilliness, tremulousness, and 
an evident alleviation of the sensations of heaviness of 
the head, dulness of the mind, and dimness of sight. 

" Gelseminum has direct relation to the incipient or 
congestive stage of cerebro-spinal meningitis, and also in 
some degree to the consequent inflammation. An attack 

* Dr. Ad. Lippe, Am. Horn. Review, Vol. V. p. 438, April, 18G5. 



166 NON-SYPHILITIC DISEASES. 

of this disorder is usually sudden, and is ushered in by a 
severe chill, accompanied by evident congestion to the 
spine and brain, with its ordinary symptoms, — among 
which dilatation of the pupil is, I believe, always seen. 
This state is followed — except in those cases which die 
collapsed — by reactionary fever of corresponding vio- 
lence. In such a condition of the system, no remedy is 
so homoeopathic as Gelseminum." Searle. 

Aconite — in some respects similar to Gelseminum * 
— produces restlessness; while Gelseminum produces 
(drowsiness) prostration and even paralysis of the 
muscular system. In addition, we note that Aconite 
has violent thirst, and bright redness of the face ; while 
Gelseminum has moderate thirst, or little or none, and a 
crimson hue of the cheeks. 

Kreosotum. My attention is called to this remedy by 
J. J. Detwiler, M. D., of E'aston, — by whom it has been 
found useful under the following conditions : 

Discharges from the bowels, with symptoms peculiar 
to Kreosotum. Rigidity of the muscles. 

Yesicles round the mouth, white-tipped, filled with 
water. Yesicles on the tongue, like little blisters. 

Eruption peculiar to K., — more like flea-bites. 

Fetor, similar to the smell of Kreosote. 

Chlorine. Has also been recommended in this disorder. 

Oxalic acid. Eruption, or mottled appearance of the 
skin in circular patches.f Paroxysms of tetanic convul- 

* See a comparison of these two remedies in Gross's Comparative 
Materia Medica. Curiously enough, this comparison, which Gross 
never saw, — it having been prepared after his decease, by the 
joint contribution of the American editor and his collaborators, — 
is the only one which was republished by his reviewers as a spe- 
cimen of his life-work ! Sic vos non vobis ! 

f Dr. W. Williamson, to whom I am much indebted for valuable 



NON-SYPHILITIC DISEASES. 167 

sions, which arrest the respiratory process entirely for 
the time being. Acute pain in the back, gradually ex- 
tending down the thighs, occasioning, ere long, great 
torture. Great prostration. 

This remedy deserves to be carefully studied in severe 
cases of Spotted Fever ; and it may prove to be suited, 
especially to its advanced stages, after exudation. Com- 
pare Apis. 

Baptisia. "Has many symptoms which resemble 
very much those which are said to occur in the so-called 
■ Spotted Fever. 7 Dr. Rogers claims to have used it 
with benefit in his own case, during an attack of ' Cerebro- 
spinal fever,' which was epidemic in his locality. We 
would suggest to our colleagues a careful comparison of 
the symptoms of this dreaded malady with the proving 
of Baptisia. It may be found a valuable remedy in the 
treatment of that fatal epidemic." * 

Cimicifuga. Successfully employed by Dr. Searle,f 
from whose "Xotes on the Xew Remedies" the follow- 
ing, partly pathogenetic and partly clinical, indications 
are extracted: "Severe chills, nausea and vomiting, de- 
lirium and acute pain in the head, shooting down the 
spine, with rigidity of the muscles of the back," — symp- 
toms of incipient cerebro-spinal meningitis, — in a feeble 
woman of fifty years, — which w^ere removed in twenty- 
hints derived from his own successful experience in treating this 
disease, informs me that Dr. Hering, when engaged in proving 
this drug upon himself, was for a long time marked by the 
"spots." The first symptom, given above, is quoted in S. Codex, 
from Christison. 

* Hale, Materia Medica of New Remedies, p. 120. 

f New Remedies, p. 209. 



168 NON-SYPHILITIC DISEASES. 

four hours. Alternate tonic and clonic spasms. Pain in 
every portion of the head, chiefly in the vertex and occi- 
put, extending often to the shoulders and down the spine, 
accompanied by a delirium which perfectly simulates 
maniaa-potu. The pain is sometimes paroxysmal, and 
is pressive, throbbing and aching in its nature, and at- 
tended by tremor and illusions of vision. Intense, 
throbbing pain, like a ball driven from the neck to the 
vertex, with every throb of the heart. Intense and per- 
sistent pain in the eye-balls, which are dull, aching and 
sore. Dilatation of the pupils. Swollen tongue. Dys- 
phagia. It has cured Chorea when attended with almost 
complete loss of the power of swallowing. 

Sulphuric acid. This remed}^ has the petechia, or 
rather maculated spots, with soreness of the flesh, and 
great and sudden sinking of strength. It has, also, jerks, 
cramps, and other minor spasmodic ^symptoms, and sub- 
sultus tendinum, and, therefore, may be indicated and 
found useful even in the more advanced stages of the 
disease. 

Eupatorium perf. Has been found curative in this 
disorder, by Rafinesque, (allopathic, in 1820,) and later 
by Drs. Pratt, Belden, and others. It is indicated by 
severe aching and soreness in the limbs; aching pain 
and soreness, as if from having been beaten, in the calves 
of the legs, small of the back, and in the arms above and 
below the elbows ; aching in the bones of the extremities, 
(as if the bones were broken,) with soreness in the flesh ; 
copious perspiration, which gives no relief; cramps; 
thirst before the chill ; — nausea and vomiting after the 
chill.* 

* Materia Medica of New Remedies, p. 352. 



NON-SYPHILITIC DISEASES. 169 

Veratrum viride. This most important and powerful 
remedy has proved curative in a desperate case of trau- 
matic eerebro-spinal meningitis — arachnitis — which was 
strongly marked by dilated pupils ; the muscles of the 
back of the neck contract, drawing the head back on the 
shoulders ; delirium ; clonic spasms ; complete opistho- 
tonos ; during the spasm, the heels almost touched the 
head, forming a hoop of the body. Another case, equally 
hopeless, occurring after scarlatina, was cured by the 
Verat. v., in which was observed "a strip, about six 
inches wide, extending from the crown of the head to the 
bottom of the spine, very pungently hot and dry, reddish 
in appearance, with several large and small petechia, 
like mosquito bites, scattered over the inflamed strip." * 

Our limits will not allow of any attempt to present 
the special indications for this remedy, in this connec- 
tion ; but enough has been given to show that no one 
can expect to do justice to such cases, who does not care- 
fully study its entire literature — both the pathogenetic 
and the clinical. 

Alumin. met. Dr. Ruhfusf narrates a case of com- 
plicated disease of the brain and nervous system— -chronic 
eerebro-spinal disease — successfully treated by him, with 
Alumin. met. 30 , after some advantage had been derived 
from Bell., Phosph., and Xux vom. 

Nux vom., Rhus tox., and Cuprum acet. Dr. H. Ben- 
nett, of Rochester, N. Y., reportsj a case of spotted fever, 

* Materia Medica of New Remedies, p. 1039. 

f Allgemeine Horn. Zeitung, Vol. LXYIII. p. 75, quoted in Am. 
Horn. Review, Vol. IV. p. 511. 

\ North American Journal of Homoeopathy , Vol. XVI. p. 9. Au- 
gust, 1867. 
15 



170 NON-SYPHILITIC DISEASES. 

in a lad of thirteen years, recently from England. He 
was taken with severe pain in the head, on Thursday ; 
the same evening became delirious, and had spasms fre- 
quently during the night. On Friday, a. m., his head 
was drawn back ; pupils dilated ; livid spots upon face, 
breast, arms, and lower extremities ; pulse 115 to 120 per 
minute. Yery feeble ; jaws firmly set part of the time ; 
had occasionally vomited a green, bilious matter the pre- 
vious night. He got jSux v., Rhus t, and Cup. acet., 
alternately, at intervals of fifteen minutes ; gradually im- 
proved, and finally recovered, in a few days, under the 
same medicines continued at longer intervals. 

Hyoscyamus. Double Vision; convulsions; delirium. 

Lycopodium. Sopor; sinking of the lower jaw; fan- 
like motion of the nostrils ; jerkings of the body and 
limbs. Baue* 

Opium. Stupor; spasms; drawing the body back- 
wards and rolling it first to one side, then to the other ; 
deep, slow breathing ; very quick, or else very slow 
pulse ; often violent mental emotions, fear, grief, fright, 
which act like a blow, stunning the whole nervous sys- 
tem. Raue.^ 

Conium, Nux v., and Phosph. All have some symp- 
toms often occurring in this short-lived disease, and 
should be carefully studied. In this, as in many other 
dangerous forms of disorder, the true homoeopathic, and 
therefore the only life-saving remedy, in a particular case, 
may not prominently suggest itself from among those 
which are apparently indicated, so that, unless it is dili- 
gently sought for, the patient may be lost who might have 
been saved. 

* Special Pathology, by C. G. Raue, M, P,, p. 14. f Loc. cit. 



NON-SYPHILITIC DISEASES. 171 

We are aware that there are other remedies which 
have been used in this form of disorder, or which may 
be indicated in cases yet to occur ; and trust that in re- 
spect to them, as well as to those here mentioned, other 
physicians will contribute the results of their observa- 
tion and experience. And we close with a single re- 
mark : the remedy which is indicated by the leading, 
d} r namic, characteristic symptoms, — or by the general 
totality of the symptoms, — will prove beneficial even in 
desperate cases ; although its pathogenesis does not re- 
cord the livid " spots," which often form the most re- 
markable objective features of cerebro-spinal meningitis. 
These " spots " represent the ultimate consequences of 
the disorder, in partial failure of capillary circulation ; 
just as corresponding insensible spots * indicate a similar 
partial failure of innervation, — and it is well known that 
very few of our remedies have been proved to the ex- 
tent of developing all their ultimate, objective, pathologi- 
cal symptoms.] 

TABES DORSALIS. — This affection of the spinal 
marrow, which affects more particularly young men, is 
either the direct or indirect consequence of sexual ex- 
cesses, bodily fatigue, or cold. It commences with an 
unusual disposition to weariness in the lower limbs and 
back, and inability to bear fatigue, or to stand or stoop 
for any length of time ; after a while the muscular sensa- 
tions become altered, the patient fancies, when walking, 
that he is stepping on wool, or that the floor is shaking 

* "Along the course of the femoral nerves there were several 
spots, in which the skin was devoid of sensibility. " Am. Rom. 
Review, May, 1864, Vol. IV. p. 511. 



172 NON-SYPHILITIC DISEASES. 

or soft, and gradually he loses, without special attention, 
the faculty of using his muscles. In the dark, or when 
his eyes are closed, he loses his sense of equilibrium, and 
staggers; he becomes incapable of buttoning his coat, 
and all his motions are awkwardly and hurriedly per* 
formed ; even when walking he cannot arrest his pro- 
gress without holding on to something, and the most 
trifling obstacle disturbs him. 

Accompanying symptoms are, a feeling as if ants were 
running up and down the spine, drawing and shooting 
pains, sensitiveness to currents of air, pains in the abdo- 
men and chest, shortness of breath, and palpitation of 
the heart. 

Treatment. — The precautions noticed under the 
heads of self-abuse, &c, must be rigidly observed in this 
complaint, and the diet must be light and nourishing. 
The most appropriate remedies are : -= 

Arsenicum, which can be given when the patient has 
been exhausted by excesses, his flesh being pale, soft, 
and bloated ; attended with great palpitation of the 
heart, pulling and tearing pains in the back and legs, 
and formication along the spine. 

Graphite is very useful, particularly when the com- 
plaint occurs in females, and is attended with great 
weakness in the legs and back, with palpitation, dulness 
of the senses, numbness or torpor of the genital organs, 
and pains in the chest. 

Acid phosphoricum can be given when there is exces- 
sive formication, and heaviness which increases to pain 
in the lower limbs ; with painful spasms in the chest and 
diaphragm, and palpitation of the heart. In cases of 
great emaciation, with languor of the body, mental op- 



NON-SYPHILITIC DISEASES. 173 

pression, and feeling as if the hands and feet were gone 
to sleep, this remedy is veiy efficacious. 

Lycopodium can be employed when there is total 
relaxation of the nervous system, with great emaciation, 
extreme weariness and weakness, coldness and deficiency 
of animal heat, the lower extremities being particularly 
cold and heavy. 

Nux vomica is very frequently of great service in this 
complaint, particularly when, from spermatorrhoea or 
sexual excesses, the patient is brought to a state border- 
ing on imbecility, the whole body being insensible, as if 
asleep, the lower limbs constantly trembling, and at- 
tended with fluttering of the heart; there is great lia- 
bility to cold, even the slightest current of air producing 
a disagreeable sensation on the skin ; in fact, the whole 
of the organs of sense are in a state of great nervous 
irritation, and attended with great weariness ; even the 
gait is unsteady, and the patient reels as if intoxicated. 

Calc. carb. is excellent when the feet go to sleep, and 
pains as from bruises, with lameness, occur in the small 
of the back, during motion and even when sitting or 
standing ; or when the hands and feet are cold, with 
paleness of the face, and frequent palpitation of the heart. 

HYDROCELE, Dropsy of the Scrotum. — This is 

caused by an infiltration of serous fluid either into the 
cellular tissue of the scrotum, the tunica vaginalis of the 
testes, or of the spermatic cord. It is when the tunica 
vaginalis is implicated, that the term hydrocele is applied 
more especially. It is common to all ages, and may 
arise from constant riding on horseback, bruises, contu- 
sions, trusses badly applied, or inflammation of the 
16* 



174 NON-SYPHILITIC DISEASES. 

urethra and testicles. The tumor is soft, semi-trans- 
parent, pyriform, progressively enlarging without pain ; 
if percussed simultaneously on both sides, fluctuation is 
manifest; the safest diagnostic, however, is the trans- 
parency of the swelling, a light being held in front of 
which, is to be examined from behind. The contained 
fluid is generally clear, yellowish, and smells of semen, 
but occasionally it is turbid, green, brownish, or deep 
brown. When found mixed with blood, it is termed 

HEMATOCELE. 

Treatment. — -Cases of recent origin in young people 
may generally be cured by the following remedies : 

Calc. carb., Spongia, are more particularly adapted 
for scrofulous patients. 

Conium, when the affection can be traced to mechani- 
cal injuries. 

Dulcamara, should it arise from cold. 

Digitalis, if there is constant disposition to urinate. 

Graphite is appropriate for persons subject to eruptions 
on the skin, habitual constipation, and dropsical swelling 
of the prepuce and scrotum. 

Mercurius is useful should the patient have been 
troubled when young with soreness and swelling of the 
genital organs, especially of the prepuce, and is very 
chilly and liable to take cold during damp weather, and 
also when his flesh is soft and flabby, with tendency to 
perspiration at night. 

Pulsatilla, if the swelling is of a bluish color, in per- 
sons subject to varicose veins, and of a lymphatic consti- 
tution, with blue eyes and light hair. 

Rhus toxicodendron is very useful when the left side 
of the scrotum only is affected. 



NON-SYPHILITIC DISEASES. 175 

Helleborus niger is of great importance in dropsy of 
the scrotum, when the desire to urinate is great, although 
but a small quantity is discharged ; the body being gen- 
erally cool, with occasional tendency to puffiness of the 
lower limbs. 

Digitals can be given when the swelling does not per- 
mit the rays of light to pass, or only very feebly, arising 
from the fluid being dark-colored ; and particularly when 
the patient complains of being bilious, and is otherwise 
very poorly from indigestion. 

Arsenicum, Cinchona, cannot be dispensed with when 
the patient is in a weak and debilitated state, with great 
weakness of the vessels, and tendency to general dropsy. 

Silicea is greatly recommended for this disease, espe- 
cially in strumous habits, and can be given in such cases 
in doses the same as prescribed for Mercurius. 

When an operation is imperative from the great accu- 
mulation of fluid, a single dose of Arnica will be suffi- 
cient to ward off any traces of inflammation. 

It may here be necessary to state that the dangerous 
plan of injection after au operation, for the purpose of 
obliterating the cyst containing the fluid, cannot be too 
strongly reprobated, as the disease will generally yield 
to appropriate remedies. 

VARICOCELE; CIRSOCELE. — These two terms are 
almost synonymous, and are used to describe the swelling 
of the veins of the testes, which may often be mistaken 
for hernia (rupture). Its slow disappearance, however, 
in a horizontal position, and its equally slow return in 
an upright one, constitute a characteristic difference be- 
tween the two affections. It is liable to affect persons 



176 NON-SYPHILITIC DISEASES. 

subject to piles or varicose veins, but may also be pro« 
duced from sexual excesses, excessive costiveness, the 
pressure arising from a large hernia, constant riding on 
horseback, or continual standing during work, badly ap- 
plied trusses, and venous congestion of the abdomen or 
of the portal system. It presents the following symp- 
toms. A soft, knotty, elastic swelling extends from the 
scrotum to the inguinal ring ; the nodosities disappear 
under pressure, but reappear again rapidly when that is 
removed; the scrotum hangs down relaxed, and the 
swelling when pressed imparts to the hand the sensation 
of a bundle of worms. Dull pains in the loins and kid- 
neys are also experienced, with a feeling of heaviness and 
drawing in the spermatic cord and testicles, but a sensa- 
tion of relief is afforded by supporting the scrotum with 
the hand ; there is also a good deal of perspiration on 
the inner side of the thigh, which is in contact with the 
diseased testicle. Although this affection never endan- 
gers life, at times the pains become very severe, and 
strike to the renal region and thighs, so as to impede 
walking ; depression of spirits, fretfulness, and hypochon- 
driasis are sometimes the consequences of it. 

Treatment. — This affection often proves very intrac- 
table, and it is only possible in some instances to give 
temporary relief. In all cases a suspensory bandage 
should be worn. 

Pulsatilla, Nux vomica, Sulphur. These three reme- 
dies, which are generally the most efficacious in the treat- 
ment of varicose diseases, can be employed with advan- 
tage in this complaint. 

Pulsatilla is likely to prove most useful when the pa- 
tient is of a mild disposition, and subject to venous con- 



NON-SYPHILITIC DISEASES. 177 

gestions, with a bluish appearance of the veins of the 
part. 

Nux vom., Sulphur, are to be preferred when there is 
constipation and derangement of the stomach, with irri- 
table disposition. 

Aconitum is to be administered when there is great 
engorgement of the vessels, and the tone of the vessels is 
very much impaired. 

Belladonna is useful when the patient suffers from con- 
gestion in other parts of the body (e. g. in the head), and 
when the swelling feels hot and hard, with stitching and 
throbbing pains. 

Arnica. When contusion has given rise to the com- 
plaint, the external use of this remedy is very necessary. 

Directions for Use. — -A teaspoonful of the strong Tincture to be 
mixed in half a pint of water, and applied by means of a rag, 
three times a day. 

Lachesis is indispensable should the veins assume a 
livid appearance, and there is great depression of spirits. 

Calc. carb. may be given in alternation with, or after 
Belladonna, especially if the sexual desire is very much 
excited, the skin and hair dry, and there is costiveness. 

Lycopodium can be employed in the same way as the 
last remedy, when the sexual power is very weak, and 
desire depressed. 

Sepia is frequently of service when there is chronic 
congestion of the parts, which feel very heavy and tense. 

Hamamelis Virginica. This very important medicine 
in varicose diseases will frequently prove of material 
value, when no other medicine appears capable of effecting 
any improvement. 

In very severe cases, a lotion, made in the proportion 



178 NON-SYPHILITIC DISEASES. 

of 1 to 10, from the concentrated tincture, and applied 
three or four times a day, will prove very efficient. 

Should these remedies produce no amelioration, it will 
be necessary in severe cases to remove the varicose 
vessels by means of an operation ; any inflammatory 
symptoms that may arise being combated with Aconite 
and Calendula. 

RETENTION OF URINE is either complete or partial, 
hence the three different stages of this complaint, viz., 
dysuria (bv$j difficult, and ovpov, urine) ; stranguria 
(crrpayl, drops, and ovpov, urine) ; and ischuria («*£«, to 
stop, and ovpov, urine) ; it is a symptom of many dis- 
eases, is frequently painful, and in many cases even 
endangers life. Retention of urine is caused either by 
paralysis of the nerves or muscles of the bladder, or from 
mechanical obstacles, which impede -the flow of urine, 
even though the bladder may possess its full contractile 
power ; for instance, the urine may be retained from the 
pressure of a large hernia, swelling of the testes and 
scrotum, or accumulation of faeces in the rectum. In 
women it may be caused by polypi in the uterus, fibrous 
tumors, or scirrhus, retroversion, ante-version, or pro- 
lapsus of that organ. The mechanical obstacles may be 
either stone, gravel, coagula, hydatids, masses of mucus, 
or foreign bodies closing the canal as w^ith a plug ; or 
alterations in the tissues of the urethra, stricture, swell- 
ing of the prostate gland, closing or constriction of the 
prepuce, and engorgement of the veins at the neck of the 
bladder. When the retention is complete (ischuria), 
the patient experiences a sense of heaviness in the peri- 
neal region, urging to stool without being able to gratify 



NON-SYPHILITIC DISEASES. 179 

the desire, acute pains above the symphysis pubis, ex- 
tending to the kidneys and glans penis, and greatly in- 
creased on walking, coughing, or rising from a chair, 
constant desire to pass water, with anxiousness and 
restlessness, all endeavors to relieve nature being fruit- 
less ; nausea and oppression of the chest set in, and face 
and eyes become red, palpitation of the heart, sweat, 
and vomiting next take place. As the bladder fills, it 
rises to the pit of the stomach, forming a visible tumor, 
which presses on the viscera. When the distention has 
reached this stage, the urine is gradually absorbed into 
the general circulation, while violent fever, delirium, and 
coma supervene. Death ensues, either from inflamma- 
tion or bursting of the bladder, which then discharges 
its contents into the abdominal cavity. 

Treatment. — Should the retention arise from an 
accidental delay in voiding urine, a single introduction 
of the catheter will remove the whole of the symptoms ; 
the application of a bandage dipped in cold water, caus- 
ing an immediate contraction of the bladder, will often 
prove equally effectual. When paralysis of the bladder 
occurs, the catheter should be used, and even left for 
twenty-four hours in the bladder. The mechanical ob- 
stacles in the other cases must also be met with appro- 
priate mechanical remedies. 

The following remedies relate only to those cases in 
which the retention is caused by complete or partial 
paralysis, or spasm of the bladder or its sphincter : 

Aconitum is very useful in retention of urine, with 
pressure in the bladder and pains in the loins, or when 
the urine deposits a bloody sediment, and there is heat 
at the neck of the bladder and continual urging to 



180 NON-SYPHILITIC DISEASES. 

urinate, and particular^ when febrile symptoms are 
present. 

Arsenicum. Retention as if from paralysis of the 
bladder, with difficult and painful micturition, of a scanty 
nature, and burning in the urethra at the time. 

Cannabis. Obstinate retention of urine, and nocturnal 
strangury ; or emissions scanty and sanguineous, passed 
drop by drop. 

Cantharis. Spasmodic retention of urine, with cramp- 
like pains in the bladder, with urgent and ineffectual 
efforts to pass water ; or painful emissions taking place 
drop by drop. 

Nux vomica. This remedy is of great service, par- 
ticularly when the lower part of the spinal column is 
affected, causing abortive urging to urinate, attended 
with pains in the bladder (dull pressure or burning), and 
spasmodic contraction of the urethra^ the urine passing 
drop by drop. 

Pulsatilla is very good, when, with the retention, there 
is heat in the region of the bladder, and uneasy pain 
in the abdomen, accompanied with urinary tenesmus. 

Sulphur can be given in cases when the urine is re- 
tained, and, when any can be passed, is attended with 
great pain and effort, and sometimes mixed with blood. 

The other remedies which may be consulted with ad- 
vantage in spasmodic cases are, Hyoscyamus, Bellad., 
Calc, Carbo veg., Conium, Graphite, Helleb. nig., 
Ignat., Lycop., Platina, Acid phosph., Staphys., 
Zincum. 

When mechanical causes are the origin of the reten- 
tion, surgical assistance is necessary, but material aid is 
afforded afterward by such remedies as Acon., Arn., 
Bellad., Cocculus, Ipecac, ISTux vom., Stjlph., Verat. 



NON-SYPHILITIC DISEASES. 181 

For the indications for which, vide Characteristic 
Effects. 

ENURESIS, Incontinence of Urine. — This disease, 
which is not dangerous, but exceedingly disagreeable, 
when not a symptom of incipient tabes dorsalis, most 
frequently affects old people. It generally arises either 
from weakness, or paralysis of the sphincter muscle of 
the bladder, in which cases the urine passes off in drops 
without intermission. Another variety is that of noctur- 
nal enuresis, occurring generally among children, al- 
though adults are sometimes subject to it. 

Treatment. — When this is the case, the patients 
should be roused two or three times in the night, in order 
to accustom them to regular emissions of urine ; children 
subject to it should eat and drink little before going to 
bed, and void urine previously ; they should also sleep on 
their sides, lying on the back being very injurious ; full- 
grown persons would do well to provide themselves with 
a caoutchouc convenience, to prevent the bed-clothes 
from being soaked. Cold sponging of the abdomen daily 
will be found very efficacious. 

Aconitum is very useful when the disease occurs in 
hysterical females, or is produced by fright or a cold, the 
urine being pale and watery. 

Carbo veg. is good when attended with acidity of the 
stomach, and alternating or existing simultaneously with 
palpitation of the heart. 

Causticum is efficacious in enuresis where the inclina- 
tion is frequent, with scanty emission and thirst. 

Conium can be given when the tenesmus is great, and 
the urine clear and pale. 
16 



182 NON-SYPHILITIC DISEASES. 

Digitalis is required for incontinence, accompanied 
with irregularity of the heart's action, dizziness, and slow 
pulse. 

Natri mur. is recommended for frequent and urgent 
tenesmus day and night, and often attended with copious 
involuntary emission of urine. 

Petroleum. In involuntary discharges of a reddish- 
brown and fetid urine, this remedy is very efficacious. 

Rhus tox. Incontinence of urine during rest, with 
urinary tenesmus and profuse discharge of urine. 

Sepia is generally useful when wetting the bed occurs 
during the first sleep, and when there is frequent and 
ineffectual desire to urinate. 

Sulphur is to be selected when the patient is scrofulous 
and subject to eruptions, is given to wetting the bed 
every night, and tormented with constant desire to uri- 
nate during the day. 

[Physalis Alkenkengi, in the 12th, is said to have 
cured a case of three years standing.] 

H/EMATURIA, Bloody Urine. — This is an haemor- 
rhage from the mucous membrane of the urinary organs, 
and may be divided into two species, viz., active, and pas- 
sive ; it may arise from the kidneys, bladder, or urethra. 
In the former case, the pain is very acute in the back, 
and is accompanied with chills, anxiety, urging to uri- 
nate, and great numbness of the thighs. If the blood comes 
from the bladder, the patient feels a pain in the hypo- 
gastric region, heat, and itching in the urinary organs 
and at the anus ; the pain extends to the perinseum and 
the glans penis, the urinary tenesmus is great and fol- 
lowed by the emission of a sanguineous fluid. When the 



NON-SYPHILITIC DISEASES. 183 

urethra is the seat of the disease, the blood is pure, not 
mixed with urine, and its flowing out is not preceded by 
urging to urinate. When the urine is mixed with pus, 
the matter becomes very serious, and great skill is re- 
quired to conduct the case to a favorable issue. 

This affection is seldom idiopathic, and usually befalls 
persons of an advanced age, and men more frequently 
than women. In some cases but very little blood is 
passed, whilst in others the haemorrhage is so consider- 
able as to endanger life. 

Treatment. — In order to remove any cause of con- 
gestion in the diseased organs, all spirituous beverages, 
animal food, and substances that tend to excite the sexual 
appetite, must be avoided. When the complaint has 
arisen from sedentary habits, the suppression of piles, 
or of the menses, the patient should take frequent exer- 
cise in the open air. 

Aconitum, when the patient is of a plethoric habit, or 
the disease has arisen from external violence. 

Cantharis can be employed when micturition is painful 
and difficult, with violent cutting and spasmodic pains 
in the hypogastric region, the urine is mixed with blood, 
or blood and pus, or blood alone is continually dropping 
from the urethra. 

Camphor is to be employed when the complaint has 
arisen from the internal use of Cantharis, or from the 
application of a blister. 

Carbo veg., Arsenicum, are frequently required after 
the latter medicine, where there still remains burning in 
the urethra, &c. 

Mezereum, Millefolium, are of great importance in this 
complaint ; the former can be used when the pains are 



184 NON-SYPHILITIC DISEASES. 

trifling and the blood rarely or ever coagulated [a 
crampy pain in the bladder, and after that bloody urine 
is voided] ; the latter, when the haemorrhage is consider- 
able, the blood having a tendency to rush to the parts 
affected, and the urging to urinate excessive. 

Nux vomica, Sulphur, Calc. carb. These remedies 
are most useful when suppression of piles, or a free in- 
dulgence in spirituous liquors has brought on the com- 
plaint, and there is painful aching in the back, attended 
with smarting in the urethra. They should be given in 
the order here marked, Calcarea being preferred should 
the blood be discharged in clots. 

Pulsatilla is more useful for females with discharge of 
dark-colored clots ; although it may be prescribed for 
males, when there is constrictive and cutting pain around 
the navel extending to the back, with burning in the 
urethra. 

Mercurius is of great service when the blood is dis- 
charged during sleep, and often attended with seminal 
emissions. 

Cinchona, Nux vom., Phosphorus, Sulphur, Calc. 
carb., are required when venereal excesses have brought 
on the complaint, which arises from sheer debility of 
the body generally, and the blood is more or less in a 
morbid state, with deficiency of fibrin. 

Clematis, Hepar sulph., Uva ursi. When hematuria 
is accompanied with purulent deposit, these remedies 
will be found in many cases to exert a favorable influence. 

Clematis is useful when puriform discharge, attended 
with burning sensation at the commencement of urina- 
tion, is present. 

Hepar sulph. is more indicated when there has been 



NON-SYPHILITIC DISEASES. 185 

considerable inflammation of the mucous membrane, 
either of the urethra or bladder, followed by greenish or 
yellow discharge of pus, or urine of a blood red, or 
brownish red, flocculent, and covered with a greasy 
pellicle. 

Uva ursi may be given for slimy purulent urine, at- 
tended or not with hematuria. 

[Constant urging to make water and straining, with 
discharge of blood and slime; or constant straining 
without any discharge at all, or only a few drops of 
urine, after this cutting and burning in the urethra, 
which is preceded by a discharge of blood ; hard stools. 
— Raue.] 

[Terebinthina, indicated, according to Raue, when 
"the blood is thoroughly mixed with the urine, forming 
a dirty, reddish brown, or blackish fluid, or a coffee- 
ground-like sediment ; burning, drawing pains in the 
kidneys ; pressure in the bladder, extending up into the 
kidneys when sitting, disappearing when walking about ; 
before urination, pressing and straining in the bladder 
when sitting, going off when walking ; burning in the 
bladder, worse during micturition; in complication with 
scorbutic affections, and if caused by living in damp, 
moist dwellings." 

Terebinth succeeds well after Occimum canum; a 
female, whose painful haematuria was temporarily re- 
lieved by Occimum c, 2. c. (the 6th had no effect), was 
permanently benefited by Terebinth. 3 ] 

[Copaiba. Very similar in its action, and in its indi- 
cations to Terebinth, is the famous Balsam Copaiba. 
16* 



186 NON-SYPHILITIC DISEASES. 

In several cases of Hematuria, in females, cases of un- 
doubted disease of the kidneys themselves, the Copaiba 
proved promptly curative. In one case of some months 7 
standing, which several physicians of the old school 
vainly tried to relieve, and in which I had, with much 
study, determined the Horn, remedy to be Terebinth, its 
use was followed by marked improvement. This was a 
nursing woman, who had also diarrhoea. Her diarrhoea 
and other stomach symptoms had been removed by Puis., 
but she complained of pain all the time in the urethra ; 
burning pain ; frequent micturition ; and pain in back 
and kidneys ; much blood mixed with the urine. While 
taking the Terebinth, which seemed to be curing her, 
she was persuaded, by an old woman, to take the Balsam 
Copaiba. She took about two ounces in the course of 
two or three days, and was immediately and permanently 
cured. I can, myself, vouch for the -iong standing and 
severity of the case; and for the fact of the woman's 
complete restoration to health and strength under the 
influence of the Copaiba. There was no reason to suspect 
the presence of any gonorrhceal complication or infection 
in this case. Several similar cases have been reported 
to me, as made with this same remedy in the hands of 
the laity.] 

[Lycopodium is often indicated when there is either 
gravel (red sand in the urine) or chronic catarrh. See 
also Sarsaparilla, in the next section.] 

[Nitric Acid is said to be specific in active hemorrhage ; 
it is, of course, all the more indicated in mercurialized 
persons ; by tenesmus after urinating, and in gonorrhceal 
cases.] 



NON-SYPHILITIC DISEASES. 187 

[Secale c. In passive hemorrhage, as if from dissolu- 
tion of the blood ; with coldness of the body (disposition 
to throw off the clothes); great prostration.] 

[Sulphur. After suppressed cutaneous eruptions, and 
hemorrhoidal discharges; stinging and burning in the 
urethra.] 

[Occimum Canum. Indispensable in haematuria, with 
venal colic, or cramps. See " Indications of the Medi- 
cines/' in this work, for symptoms.] 

[Erigeron and Hamamelis have been empirically re- 
commended in hematuria. To this may be added 
Urtica urens.] 

[For further indications of most of these remedies, and 
others not here named, consult Raue's Pathology, and 
the pathogenesis of the remedies themselves.] 

CALCULUS AND GRAVEL. — Under certain condi- 
tions, arising generally from the presence of a gouty or 
rheumatic diathesis, the urine, as it cools, deposits small 
crystals, which assume various forms, their surfaces 
being smooth, facet-shaped, or rough, according to cir- 
cumstances, discernible to the naked eye ; varying in 
consistence and size, from a fine pulverulent deposit like 
sand, to that of bodies as large as a pea. They also 
differ considerably in color ; when they consist of urate 
of ammonia, with or without free urea, their color is 
red, and the urine accompanying them gives an acid re- 
action. 

When the gravel is formed in the kidneys, although 
generally red, it may be reddish-brown, brown, yellow, 
grayish-white, or ash-colored. There are, perhaps, but 
few complaints which are so modified by external circum- 



188 NON-SYPHILITIC DISEASES. 

stances as gravel ; a patient, leading a sedentary life, 
suffering from deposits of urea, uric acid, or urate op 
ammonia, the urine giving an acid reaction, when re- 
moved into the country, and taking plenty of exercise, 
will find in a day or so that the deposit has totally 
changed its character, and that oxalate of ammonia, 
or of lime, is now present, with an alkaline reaction of 
the urine. Again, a person having calculus in the 
bladder, formed from the acid deposit, if placed under a 
course of alkalies, so far from their removing the com- 
plaint, they will often aggravate the original mischief, 
by causing an alkaline deposit upon the acid calculus. 
It hence follows that it is not so much the excessive 
presence of azote in the blood, as a certain morbid dispo- 
sition of the renal vessels, which causes the abnormal 
secretion. Nor is strict attention to diet always effica- 
cious, as the less azote the food contains, the greater the 
deposition of acid or alkaline formations. It may be as 
well to add, that an acid deposit is convertible into an 
alkaline one, and vice versa; for this reason, that the 
ultimate elements of both are the same, and only differ 
in their proportions, or the tendency, at the time, of the 
renal vessels to secrete lime or phosphates. Urea, uric 
acid, ammonia, all contain azote and hydrogen, the two 
former carbon and oxygen as well, whilst oxalic acid, 
which forms the oxalates, consists of carbon and oxygen 
alone.* Hence the exceeding difficulty and the great 

* Urinary Deposits. — Urea. — C 2 H*N 2 2 or C 2 NO+NH 3 +HO. 
This constituent principle of urine appears under the form of 
silky crystals or prisms, with four transparent faces, having a 
fresh savor, analogous to that of nitrate of potash ; it is inodor- 
ous, and gives no acid or alkaline reaction. 



NON-SYPHILITIC DISEASES. 189 

care required in treating this complaint, which, if mis- 
managed, leaves to the unfortunate sufferer no resource 

Uric Acid. — C 10 N 4 HK) 6 . This acid is deposited from urine as a 
yellowish powder, which adheres strongly to the vessel. When 
purified, it presents itself as white crystalline scales, soft to the 
touch, is inodorous and without taste, is soluble in 1150 times its 
weight of boiling water, and then changes litmus-paper to a bright 
red. 

Urate of Ammonia. — NH 3 +C 10 N 4 H 4 O 6 . Deposited as a gray 
sediment when the urine begins to cool, but, in intermittent fevers 
and acute rheumatism, the deposit is reddish ; it is often found 
in calculi. When treated with caustic potash, the ammonia is 
liberated. 

Oxalate of Ammonia, — N 2 H 6 C 2 3 +HO. This salt forms crystals, 
which are elongated, colorless, and transparent prisms, rather 
less soluble in water than oxalic acid, and completely insoluble 
in alcohol. 

Phosphate of Lime. — 8CaO-f-3Ph0 5 . This is a whitish or gray 
deposit, soluble without effervescence in diluted acids. 

Oxalate of Lime. — CaO+C 2 3 . Mural stones. Calculi formed 
entirely of this deposit are very rare ; when pulverized and 
treated with sulphuric acid, they disengage a gas (carbonic oxide) 
which burns with a bluish flame ; they are also soluble without 
effervescence in nitric acid. 

Cystine. — These calculi are very seldom to be met with ; they 
are to be recognized by their ready and complete solution in 
caustic potash, and if the solution be boiled, after an addition of 
acetate of lead, it becomes black by the formation of sulphuret of 
lead. 

Ammoniaco - magnesian Phosphate. — Ph 2 M0 5 N 2 H 6 H 2 0. These 
calculi are grayish-white, and readily soluble in acetic acid ; 
when treated with the perchloride of iron and ammonia, the 
solution yields a sediment of phosphate of iron, the magnesia re- 
maining in solution. 

Benzoic Acid. — C u H 10 O 3 . Is sometimes found in the composi- 
tion of urinary deposits, the urine being then generally very fra- 



190 NON-SYPHILITIC DISEASES. 

but that of an operation for the removal of the calculus. 
Should the deposit take place in the bladder itself, or any 
foreign body (such as a broken catheter) get lodged in 
that organ, the urine is sure to form a coating upon it, 
which gradually increases in size, till a veritable stone 
is formed which can only be removed by an operation. 
When this occurs, the symptoms of the disease are 
greatly intensified. The pains become excessive, and 
extend through the whole of the hypogastrium, and con- 
vulsions and irritative fever are frequently the result. 
Retention of urine and urging to urinate accompany 
these symptoms, and are followed in a day or two by 
the emission of red, or black urine, mixed with blood ; 
haematuria and inflammation of the kidneys often accom- 
pany lithiasis (stone in the bladder). 

Treatment. — When this complaint is first suspected, 
the first thing to do is to daily test the urine with pieces 
of litmus and turmeric papers. Should the urine be 
acid, the litmus-paper will change from blue to red; or if 
alkaline, the turmeric paper loses its yellow color, and 
assumes a brown tint. When the urine is acid, a vege- 
table diet exclusively will be generally the best, or an 
animal one when the deposit is white and alkaline ; much, 
however, must depend upon circumstances, and the pa- 
tient will often be called upon to display his judgment 
and discretion in this matter. Cheese, and other indi- 
gestible forms of azotized food, are very favorable to the 
formation of uric acid, and must therefore be avoided, 

grant. When purified, it crystallizes in hexagonal needles, or in 
white, shining, flexible, and silky lamellae, of a smarting, acrid 
savor, unalterable in the air, slightly soluble in water, but 
readily so in boiling water and alcohol. 



NON-SYPHILITIC DISEASES. 191 

as well as sour drinks or acid fruits, &c. All diseases 
having a tendency to produce retention of urine are very 
liable to favor the development of this complaint, and the 
urine in these cases should be very carefully watched. 
When there is no hereditary predisposition, or no organic 
disease of the kidneys, gravel is generally easily cured, 
particularly so if uric acid is the constituent ; but the 
presence of the phosphates denotes organic disease of 
the mucous membrane of the kidneys or bladder, and is 
exceedingly intractable. 

In gouty or rheumatic patients, this complaint is 
usually only a symptom of the disease itself, and can only 
be subdued with the eradication of the original taint. 

Diet. — A strict diet is the best prophylactic against 
gravel, and is sufficient sometimes to arrest the formation 
of the urates in the kidneys. When the urine is deep red, 
or bloody, animal food is absolutely poisonous, and light 
vegetable diet is to be enforced. When it is induced by 
the exclusive use of heavy food, cheese, farinaceous com- 
pounds, or food containing much saccharine matter, and 
the constitution is debilitated, animal food should be used 
in moderation ; wine, beer, and spirits, are to be carefully 
avoided, and fresh pure water, rice, barley, or toast and 
water substituted. The influence of water on this com- 
plaint must not be overlooked ; when possible, a residence 
among the mountains, or wherever the water is nearly 
chemically pure, is recommended. The solvent power of 
pure water is so great, that secretions from the kidneys, 
insoluble in ordinary water, are removed from the body in 
a state of perfect solution, when the better water is drank ; 
the absence, too, of earthy salts in the water relieves the 



192 NON-SYPHILITIC DISEASES. 

secreting vessels of much unnecessary work. Where pure 
soft water is not to be had, filtered rain-water is the best 
substitute. 

Belladonna is very good in cases where the urine is 
of a gold or citron color, depositing a red sediment, with 
nocturnal pressure in the bladder, and shooting, burning 
pains in the region of the kidneys. 

Cannabis is useful when the urine is turbid, as if mixed 
with blood or pus (or when small calculi are discharged), 
and attended with strangury and pain in making water. 

Colchicum can be given when the urine is scanty, and 
of a bright red color, or brownish and blackish, as if con- 
taining blood ; it is also very useful in whitish deposit, 
with great burning in the urethra. 

Uva ursi. When the kidneys are affected, and the 
urine is albuminous, or mixed with pus, and deposits a 
white sediment, this remedy will be found useful. 

Sarsaparilla can be given for sanguineous urine, or 
urine charged with acrid and turbid matter, and deposit- 
ing gravel. 

The following remedies may be also studied with ad- 
vantage : 

For opalescent urine — Calc, Cinchona, Hep., Iod., 
Petrol., Phosph., Puls., Sulph. 

With gelatinous sediment — Coloc., Puls. 

With gravel, sand, or stone sediments — (1) Lye, 
Sarsap. (2) Calc, Cann., Nux v., Petr., Phos., Sep., 
Sil. (3) Ant., Calc, Canth., Cinchona, Lach., Natr. 
m., Nitr. acid, Puls., Thuja, Zinc 

Loamy sediment — Sars., Sep., Sulph., Zinc 

Sediment, resembling flour, chalk, or lime — Ant. t., 
Calc, Cinchona, Graph., Merc, Natr. mur., Phosph. 
acid, Sulphur. 



NON-SYPHILITIC DISEASES. 193 

Reddish brick-colored sediment — (1) Canth., Cin- 
chona, Lyc, Xatr. mu&, Xux v., Phos., Puls., Sep., 
Scilla. (2) Acon., Ant., Arn., Dulc, Lach., Xitric 

ACID, SlLIC. 

Whitish sediment — Colch., Dulc, Hep., Xitric acid, 
Petr., Phosph., Phosph. acid, Rhus, Sulph. 

Smelling strongly of ammonia — Carbo veg., Iod., 

MOSCH., XlTRIC ACID, PETR., PHOSPH. 

BLENORRHCEA VESIC/E, Catarrh of the Bladder: 

This is a mucous or puriform discharge from the lining 
membrane of the bladder, without any inflammatory 
symptoms being present ; there are two varieties, the 
chronic and the ulcerous blenorrhoea, and both are se- 
quelae of acute diseases, although they may be sometimes 
idiopathic. It is characterized by a considerable secre- 
tion of mucus, which is discharged from the bladder with 
the urine, which at first appears simply turbid, and the 
mucus suspended in it falls gradually to the bottom of 
the vessel, as a w r hitish-gray transparent layer, above 
which the urine remains clear, when precipitation has 
entirely ceased. As the disease develops itself, the mucus 
is secreted in larger quantities, and floats in the urine in 
the shape of flocks and filaments, of a white, yellow r , or 
greenish color, the urine becomes thick, and instead of 
preserving as before its acid reaction, it becomes alkaline^ 
emits an offensive odor, and is rapidly decomposed. The 
discharge of urine now becomes painful, slow, and inter- 
mittent ; the stream is sometimes suddenly interrupted, 
and after many vain exertions, a plug of mucus is expelled, 
and then the urine passes more freely. Incontinence of 
urine, especially at night, obliges the patient to urinate 
17 



194 NON-SYPHILITIC DISEASES. 

every half hour, or oftener, which is attended with pain 
in the bladder, urethra, and perinaeum. Spasm of the 
bladder frequently precedes the emission of urine, and 
disappears at the termination. 

When this complaint has been overlooked at its com- 
mencement, the general health suffers, digestion is im- 
paired ; constipation and pains in the loins, and sometimes 
paralysis of the bladder, are the consequences of this dis- 
order, which may easily become fatal, should the urine 
begin to be absorbed into the general circulation. Old 
men rather than women, individuals of sedentary habits, 
literary men, tailors, shoemakers, &c, are particularly 
liable to catarrh of the bladder, and it is met with more 
frequently in low and damp regions, and along the sea- 
coasts, than anywhere. Organic diseases of the bladder, 
mechanical or chronic irritation caused by frequent in- 
troduction of the catheter, the use of-ardent spirits, new 
beer or wine, piles or gout, the internal use of Can- 
tharis, suppressed gonorrhoea, badly treated cystitis, 
&c, are the most frequent causes of catarrh of the bladder. 

Treatment. — It will be advisable for the patient be- 
fore voiding urine, to move briskly about for a short 
time to prevent the mucus settling at the bottom of the 
bladder, which should be completely emptied before re- 
tiring at night by means of a catheter. 

In the first stage of the disease, the most useful medi- 
cines are Bell., Hyos., Merc, and Puls. 

The second stage requires Caps., Carbo veg., Hel- 
leb. nig. 

Scrofulous patients may require Con., Dulc, or Staph. 

For the spasms wilich sometimes arise — Bell., Cann., 
Canth., Digit. 



NON-SYPHILITIC DISEASES. 195 

Gouty patients require Coloc., Sabix. 

In chronic cases — Arg., Calc, Graph., Lyc. 

Purulent urine requires Caxx., Caxth., Clem., Lyc, 
Xux vom., Puls., Sep. 

Fibrinous Jiocculent urine — Axt. tart., Caxx., 
Caxth., Merc, Mez., Nitric acid. 

Slimy urine or sediment — (1) Ars., Dulc, Merc, 
Xatr. mur., Puls. (2) Ant., Caxth., Carbo yeg., 
Coloc, Cox., Hep., Xitr. acid, Xux vom., Sarsap., 
Sulph. 

JIucous threads in the urine — Antim. tart., Caxx., 
Caxth., Merc, Mez., Xitric acid. 

Viscid urine — Argext., Caxth., Coloc, Kreas., 
Phosph. acid. 

The following are the indications for the principal 
medicines : 

Belladonna. Spasm or paralysis of the neck of the 
bladder, and involuntary emission of urine, even during 
sleep ; the urine deposits a red or whitish thick sediment ; 
shooting pains in the region of the kidneys, and noctur- 
nal pressure, and sensation of motion in the bladder. 

Cannabis. Nocturnal strangury, as from paralysis of 
the neck of the bladder; stoppage of the urethra by mu- 
cus or pus ; urine bloody, and mixed with pus ; emission 
of urine drop by drop, with burning pains in the urethra 
and bladder. 

Cantharis. Retention of urine, with cramp-like pains 
in the bladder; flow of sanguineous mucus; pulsation in 
all the urinary organs ; painful sensibility of the region 
of the bladder when touched. 

Colocynth. Tenesmus of the bladder; fetid urine, 



196 NON-SYPHILITIC DISEASES. 

which soon becomes thick, gelatinous, and glutinous. 
[Aggravation before and after urinating.] 

Conium. Thick, white, and turbid urine, and mixed 
with viscid mucus, with pressure on the bladder, as if 
the urine were about to be ejected with violence. 

Dulcamara. Viscid urine, mixed with mucus ; thick- 
ening of the bladder ; involuntary emission of urine, as 
from paralysis of the bladder. 

Mercurius. The stream of urine is excessively small, 
or is even passed drop by drop ; the urine appears as if 
mixed with flour or chalk, depositing a thick sediment ; 
white, flock-like clouds in the urine ; discharge of tough 
mucus and filaments with the urine : cutting and contrac- 
tive pains in the renal region. 

Pulsatilla. Tenesmus of the bladder, with painful 
pressure ; urine gelatinous, mucous, or mixed with blood 
and pus ; or swelling at the neck of_the bladder, with 
pain when pressed, and accompanied with pain in the 
loins. 

HYPERTROPHY OF THE BLADDER.— Thickening 

of the bladder develops itself gradually, and is, perhaps, 
not detected till the urinary discharge is much interfered 
with. The tenesmus becomes troublesome, the emissions 
of urine disagreeable, and the stream is weaker, while 
the bladder is never perfectly emptied, and forms a pain- 
less globular swelling above the pubes ; there is a sense 
of heaviness in the pelvis, or pressure at the perinseuin or 
the rectum, with difficulty of passing the faeces, and 
pressure on the sacral nerves, and a feeling of numbness, 
and even paralysis of the lower limbs. When the affec- 
tion is accompanied with contraction, the bladder holds 



NON-SYPHILITIC DISEASES. 197 

only a few ounces of urine, and the patient is compelled 
to void urine every few minutes, the bladder feeling as 
if it were full. 

Treatment. — Generally speaking, this can only be 
palliative. Depending as it does on the cause of the 
complaint (for instance, catarrh of the bladder, calculi, 
affections of the prostate gland, strictures of the urethra, 
&c, &c.,) the means adopted must bear direct relation to 
that cause. 

Calc. carb. is useful when the mucous or glandular 
systems are deranged, and the urine deposits a brick-dust 
or whitish sediment. 

Dulcamara is to be preferred when the complaint has 
arisen from catarrh of the bladder, with profuse secretion 
of mucus, or when it has arisen from cold or damp. This 
remedy can often be followed by Sulphur with the best 
effects. 

Mercurius. When the complaint has been preceded 
by inflammation of the mucous membrane of the bladder 
or urethra, or as a sequel to gonorrhoea, with whitish 
sediment in the urine. 

Pulsatilla is of great service when catarrh of the blad- 
der has produced engorgement and consequent exudation 
into the tissues of the bladder, attended with slimy, mu- 
cous, or purulent discharge. 

SPASM OF THE BLADDER.— This may be a mere 
symptom of some urinary disease, or an idiopathic affec- 
tion of a purely nervous character, without any organic 
alterations. In the latter case, the patients, toward the 
end of an urinary emission, experience suddenly a violent 
constrictive pain in the region of the bladder, especially 
17* 



198 NON-SYPHILITIC DISEASES. 

in the perinasum, which extends to the urethra, and in the 
male spreads towards the glans ; sometimes it is accom- 
panied with painful erections, and affecting the groins, 
thighs, and testicles. It is also frequently accompanied 
by painful tenesmus at the sphincter ani, involuntary 
stool, and prolapsus of the rectum ; the pain, which sets 
in in paroxysms, lasts a few minutes, never more than 
fifteen to thirty minutes. There is painful tenesmus of 
the bladder, which cannot be relieved till the spasm 
abates, when a full stream of urine is emitted, which is 
clearer and paler than usual. Violent spasm is accompa- 
nied with anguish, restlessness, trembling, general ner- 
vous paroxysms, cold sweat, small and contracted pulse, 
and vomiting. 

Treatment. — The most appropriate remedies are : 

Aconitum, when the spasm is caused by a cold, ex- 
posure to damp, suppression of perspiration, or when it 
is a symptom of hysteria. 

Cantharis is good for excessive urging to urinate, with 
cutting and tearing pain in the region of the bladder. 

Nux vomica can be given when the spasm is accompa- 
nied with debility and tendency to general convulsions, 
attended with a painful desire to urinate. 

Pulsatilla is very useful for hysterical females, and 
when the spasm is characterized by constrictive pain in 
the region of the bladder, with urinary tenesmus, and in- 
voluntary emission of a little urine. 

The other remedies which sometimes are useful are 
Arsen., Bell., Calc, Carbo, Conium, Graph., Helleb., 
Ignat., Lycop., Phosph. acid, Plat., Staphys., Sulph., 
Zinc, for indications for which the reader is referred to 
the Characteristic Effects. 



CHARACTERISTIC EFFECTS 

AND 

INDICATIONS OF THE MEDICINES, 

REFERRED TO IN THIS WORK. 



PRELIMINARY REMARKS. 

The Reader should be careful to observe the assemblage of the symp- 
toms in consulting each article. A single symptom is rarely char- 
acteristic. It is the presence of one symptom (or more) simultane- 
ously with other manifestations which characterizes disease, and 
indicates the treatment. It is, therefore, essential to the right use 
of these articles, that the conditions and accompaniments should be 
closely marked, and that the symptoms should be studied in groups .* 



Acidum fluoricum. Continual dull pains, deeply situ- 
ated in the groin and region of the bladder ; pressure on 
the bladder, with sensation of warmth in the abdomen ; 
before and after urination, pain in the lower part of the 
bladder ; urine pungent and strong ; sexual desire much 
increased ; pains in the bones, burning and intermittent ; 

* "Laurie's Homoeopathic Domestic Medicine," 8vo, p. 729. 

199 



200 CHARACTERISTIC EFFECTS AND 

aching pains in the bones of the arms and legs ; bruised 
and aching pains in the os sacrum ; temper ill-humored, 
fault-finding, anxiously disposed, and given to imaginary 
fears. 

Acid nitricum. Disposition: sadness and despon- 
dency; excessive nervousness, with timidity and ten- 
dency to start; taciturnity, ill-humor, and aversion to 
work ; at times changeable mood ; weakness of memory, 
thoughtlessness, cloudiness, and dizziness of the head, 
and inability to perform any mental work. Dryness and 
itching of the skin ; ulceration of the skin, with stinging 
pains, bleeding when dressed, the ichor discharged cor- 
roding the skin. Painless ulcers, with gray inverted 
edges, bleeding readily and with secretion of ichorous 
pus. Itching, smarting, and stinging eruptions, like 
psoriasis. Ulceration of the uvula, pharynx, fauces, and 
cheeks, sometimes accompanied with_ salivation ; great 
dryness of the mouth, with thirst; soreness of the 
tongue ; vesicles on the tongue and at its edges. Thin 
stream of urine, as from contraction of the urethra ; the 
urine is pale and copious, or scanty, turbid, and offensive. 
Often, after standing, it becomes milky white, or deposits 
a quantity of red-brown gravel, or sediment, and occa- 
sionally filaments and flocks ; when the sediment is white, 
the odor is ammoniacal. Smarting and burning after 
micturition, ulceration of the urethra, with yellowish dis- 
charge ; discharge of bloody mucus from the urethra. 
Great falling off of the hair of the genital organs. Itching 
of the penis, especially the glans, under the prepuce ; red 
spots on the penis, becoming covered with scabs ; ulcera- 
tion of the glans, with elevated, lead-colored, sensitive 
edges, or superficial flat ulceration of the corona glandis, 



INDICATIONS OF THE MEDICINES. 201 

looking clean, but emitting a fetid pus ; considerable 
swelling and phimosis of the prepuce without much 
redness ; on its internal surface and border, and in the 
orifice of the urethra, chancre-like, suppurating ulcers, 
with flat edges, accompanied with violent lancinations, 
increasing towards evening, becoming worse at night, 
and hindering sleep, and much aggravated towards 
morning by violent erections. Small flesh-colored ex- 
crescences on the corona glandis, emitting fetid pus and 
bleeding when touched ; small itching pimples, bursting 
in a few days, and changing to a dry scurf; pimples, 
bursting, and changing to flat ulcers when rubbed, on a 
level with the skin, yellow, and covered with thick pus; 
these are only slightly red, and painless ; swelling of 
the (right) testicle and tearing in the spermatic cords, 
and painful feeling of the testicles when touched ; dimin- 
ished and even deficient sexual desire and copious emis- 
sion of prostatic fluid. Drawing pain in the periosteum ; 
caries of the bones of the head and face. 

Acidum phosphoricum. Lowness and sadness of 
spirits, with great anxiety about the health ; thoughtless- 
ness and forgetfulness, want of ideas, and weakness of 
mind, with difficulty of comprehension ; objects appear 
unstable, and, when walking or standing, there is great 
difficulty in keeping on his feet. Formication of the 
whole body, and soreness of the skin, with violent burn- 
ing, pricking, and red rash appearing in various parts. 
Oppression of the stomach, with drowsiness ; sour eruc- 
tations, with constant nausea, and occasional vomiting; 
coldness in the stomach. Retention of urine, terminating 
in frequent micturition, the urine being watery, — or 
dark, with clouds ; pale urine, forming thick, whitish 



202 CHAKACTERISTIC EFFECTS AND 

flocculi, — or milky urine, as if stirred with flour, and 
containing bloody jelly-like lumps, and often very fetid ; 
cutting, drawing, or burning pains in the urethra, with 
swelling of the orifice ; painful spasmodic constriction of 
the bladder ; tingling, itching, and heaviness of the glans, 
pressure and pains, or gnawing in both testicles, increased 
by contact, and swelling of the spermatic cord ; small 
red pimples on the penis, with feeling of heat ; discharge 
of prostatic fluid, when straining at stool ; falling off of 
the hair of the sexual parts ; heat and burning in sycotic 
excrescences, and soreness of the same when sitting or 
walking. 

Aconitum napellus. Heat, burning, and pressure in 
the eyes, with great intolerance of light, the vessels of 
the conjunctiva and sclerotica being very much inflamed 
and injected ; painfully tensive, red, and hard swelling 
of the lids. Enuresis, accompanied with profuse perspi- 
ration, difficult and scanty emission of urine, which is 
brown, burning, and depositing a brick-dust sediment ; 
burning in the urethra during urination ; stinging and 
pinching of the glans ; tingling in the genital organs. 

Agaricus muscarius. Difficult emission of urine, the 
stream being slow, feeble, and intermittent, or even 
passing in drops ; pressure in the region of the kidneys 
and loins ; frequent urging to urinate, with entire relaxa- 
tion of the penis. Cramp-like drawing in the groin 
during urination ; discharge of viscid tenacious mucus 
from the urethra. Frequent erections, with involuntary 
emissions; every embrace being followed by great de- 
bility and languor, profuse perspiration, and sometimes 
by burning itching of the skin. 

Agnus castus. Great deficiency of sexual instinct, 



INDICATIONS OF THE MEDICINES. 203 

the penis being so relaxed, that nothing excites it ; dis- 
charge of yellow matter from the urethra ; emission of 
mucus from the urethra, during sexual excitement. 

Antimonium crudum. Brown spots and dots, like 
small hepatic spots, here and there, especially on the 
arms ; blotches in many parts of the body, coming out, 
with itching, and disappearing in a few hours; golden- 
yellow, or brownish-red urine, depositing small red cor- 
puscles after standing some hours ; frequent micturition, 
with considerable discharge of mucus and burning in the 
urethra, with pain in the small of the back ; fine itching 
of the penis ; violent itching of the extremity of the 
glans. Dejection of spirits, with attacks of anxiety and 
uneasiness ; weakness of the head, and threatened de- 
mentia, with complete apathy ; falling off of the hair ; 
lassitude, tremulous fatigue, and heaviness in all the 
limbs after eating ; bitter eructations, like bile, with 
pressure at the stomach, like a dull cutting ; feeling as 
if the stomach were distended with food ; sensation in 
the intestines, as after a violent diarrhoea. 

Antimonii tartras. Dark yellow spots of a consider- 
able size, particularly on the fingers. The coats of the 
eye becoming redder and more sensitive, swell up, the 
ciliary vessels becoming turgid with blood ; tearing and 
burning pains in the eyes. Acute sticking pain in the 
lower portion of the bladder, violent pressure on the 
bladder, with scanty emission, and tension in the peri- 
na3um ; the urine passes in drops, the latter portion 
being bloody and accompanied with violent pains ; in- 
flammatory, red urine, depositing bloody, red filaments 
when standing, and having an acrid smell ; pustules on 
the glans ; constant sticking pain in the posterior part 
of the urethra ; tearing in the testicles. 



204 CHARACTERISTIC EFFECTS AND 

Apis mellifica. Violent inflammation of the skin, ac- 
companied with smarting and burning pains; bright 
scarlet or crimson color of the skin, accompanied with 
swelling; violent burning, itching, and swelling of the 
urethra. 

Argenti nitras. Burning and dryness of the eyes, 
with pressure, heat, and pain when moving them ; 
scarlet redness of the eyes, accompanied with intolerance 
of light and dimness of sight ; secretion of mucus, and 
agglutination of the lids ; the eyes, when opened, dis- 
close the cornea swollen and intensely injected with 
blood ; profuse purulent secretion from the inflamed 
parts ; intense pains in the eyes, the cornea gradually 
becoming infiltrated, producing haziness, and afterwards 
more or less opacity of the part. Burning, dragging, or 
ulcerative pains in the urethra, which feels swollen, hard, 
or knotty ; oozing first of mucus, then -of pus of a bright 
yellow color, accompanied with excessive pain in urinat- 
ing. The urine is often dark-colored or bloody, is longer 
in making its appearance than usual, the latter portion 
passing off with difficulty ; painful tension of the penis, 
producing chordee ; shootings, from behind, forward. 
Chancre-like ulcers on the prepuce, at first covered with 
pus, but afterwards exhibiting a pretty spacious depres- 
sion, with tallow-like coating. 

Arnica montana. Urine of a brownish color, deposit- 
ing a brick-dust sediment ; brown clear urine, which im- 
mediately becomes whitish and turbid; frequent, but 
ineffectual desire to urinate, or slow and difficult emission 
of urine ; reddish-blue swelling of the penis and scrotum, 
with inflammatory swelling of the testicles ; painful 
swelling of the spermatic cord, with lancinations from 
the testes to the abdomen. 



INDICATIONS OF THE MEDICINES. 205 

Arsenicum album. The indications for this remedy 
are generally characterized by threatening paralysis of 
the ganglionic system and of the capillary nerves, with 
consequent disposition to decomposition and mortification 
of the tissues, sudden sinking of the vital energies, pros- 
tration of strength, general collapse, solution of continuity 
(ulceration) of the organic tissues; it is, therefore, suited 
to individuals with impoverished, exhausted, and nervous 
constitutions, to leucophlegmatic temperaments with dis- 
position to catarrh, blenorrhoea, and dropsical swellings; 
to lymphatic constitutions liable to chronic eruptions, 
herpes, ulcerations, and suppurations ; and for choleric, 
lively temperaments, with disposition to melancholy. 

Excessive sensitiveness, irresolution, and disinclination 
for anything ; indifference to life, with disposition to 
commit suicide, great restlessness, with trembling, and 
weeping ; weakness of the mind and inability to think ; 
frequent yawning, with sleepiness ; grinding of the teeth 
at night, and restless sleep ; general rapid sinking of 
strength, and excessive debility, particularly of the lower 
extremities ; trembling of the w^hole body ; coldness and 
chilliness of the body, the skin being dry, scaly, and 
shrivelled ; blue spots on the skin ; little blotches, which 
heal with difficulty; ulcerations and eruptions of the 
skin, presenting a dark red, or livid, bluish-green, or black 
appearance, with the characteristic burning pain, and 
secretion of thin, acrid, burning, corrosive ichor. Re- 
tention of urine, as if the bladder were paralyzed, with 
great urging to urinate ; scanty dark yellow, or greenish 
dark-brown urine, excessively turbid, and depositing a 
slimy sediment ; involuntary micturition during sleep ; 
inflammation and swelling of the genital organs ; corro- 
18 



206 CHARACTERISTIC EFFECTS AND 

sive itching of the penis ; stinging itching of the prepuce, 
with burning in it during an erection ; acrid, thick, 
yellow discharge from the vagina, corroding the parts. 

Asafcetida. Dark red, hot swellings, with violent 
pain in the bone when touched, and discharge of fetid, 
thin, ichorous pus ; ulcers, having elevated bluish edges ; 
numb pressure, as of a body pressing upon the bones ; 
crampy jerking and drawing in the bones ; stinging in 
the bones of the leg; pains in the bones during the night. 

Aurum metallicum. Pains in the bones of the head, 
as if broken ; small bony swelling on the upper left side 
of the forehead; feeling of soreness in the nose, with 
ulceration in the nostrils, swelling of the nose, and loss 
of smell ; putrid smell and discharge from the nose ; 
bony tumors on the head, arms, and legs ; swellings, 
resembling those produced by mercury ; formication all 
over the body. Turbid urine, like -buttermilk, with a 
thick sediment of mucus ; painful retention of urine, 
with pressure on the bladder ; pressure, tensive pain, 
and swelling of the right testicle, which sometimes be- 
comes indurated. 

Barytae carbonas. Swelling of the epididymis ; numb- 
ness of the sexual organs ; considerable sweat of the 
scrotum. Tremor of the feet when standing, compelling 
one to hold on to something to prevent a fall. Loss of 
memory, vertigo, excessive irresolution and loss of self- 
confidence, great sensibility to cold; palpitation of the 
heart, especially in debilitated individuals. 

Belladonna. Feeling of burning dryness in the eyes, 
which feel as if they were full of sand ; the eyes are 
glistening, red, and violently inflamed, with profuse se- 
cretion of tears, and accompanied with burning pains. 



INDICATIONS OF THE MEDICINES. 207 

Retention of urine, which only passes off drop by drop, 
and deposits a white sediment, or turbid, like yeast, with 
reddish deposit. Wetting the bed at night, with profuse 
sw T eat. Itching titillation of the glans, resembling a 
flea-bite ; repeated tearing in the left spermatic cord, 
from below upwards, in the evening when in bed ; lanci- 
nations along the urethra. Great general debility, with 
weariness and unsteady gait, the knees tottering and 
giving way ; swelling and induration of the glandular 
system. 

Bryonia alba. Stinging, burning, itching of the pre- 
puce ; stitches in the testicles when sitting ; red itching 
rash of the glans ; swelling of the labia ; itching, burning, 
and stinging in the anterior, portion of the urethra, be- 
tween the acts of micturition. Hard swelling of the 
hypochondria; tension, burning, and stinging in the 
region of the liver, particularly on contact ; bitter eructa- 
tions and vomiting of food and bile, or yellowish-green 
mucus ; loss of appetite and strength ; heaviness and 
weakness in all the limbs. 

Camphora. Thin stream of urine, as if the urethra 
were contracted ; urine red and thick, or yellowish green 
and turbid, having a musty smell. Total absence of 
erections. 

Calcis carbonas. Urine containing a great deal of 
mucus, and depositing a white substance like flour ; urine 
having a fetid ammoniacal smell, and very clear and 
pale ; burning and soreness in the urethra during mictu- 
rition ; violent stitches in the glans ; itching of the tip 
of the glans and prepuce, which is red and inflamed ; 
aching in the right testicle; pain, as from contusion, in 
the testicle ; painful pressure and pain in the left groin, 



208 CHARACTERISTIC EFFECTS AND 

while the left testicle is spasmodically drawn up to the 
abdomen, and is also painful to the touch. Anxiety, low- 
spiritedness, and melancholy, with great uneasiness 
about the state of the health ; irritability, faintness, and 
depression, with ill-humor ; weakness of memory ; con- 
fusion and tremor in the head, with continual feeling of 
fulness in the forehead; coldness, paleness, and flabby 
feeling of the skin, with great sensitiveness to cold ; face 
pale and thin, with dark circles round the eyes ; appetite 
generally good, or even voracious, with bitter, fetid, or 
saltish taste in the mouth ; oppression of the chest and 
palpitation of the heart ; great general debility and faint- 
ness. 

Cannabis sativa. Retention of urine, or strangury, 
the urine mixed with filaments or blood ; burning, sting- 
ing, and smarting pain in the urethra during urination, 
urine mixed with mucus and pus, requiring the use of a 
catheter; spreading fan-shaped stream; frequent erec- 
tions, followed by stitches in the urethra; painless 
swelling of the whole penis ; swelling of the right and 
lower side of the prepuce ; the prepuce is dark red, hot, 
and inflamed ; continual burning of the whole prepuce 
and glans ; corrosive burning and stinging of the outer 
parts of the prepuce and the corona glandis ; soreness of 
the margin of the prepuce, and its skin is covered with 
bright red spots of the size of a pea ; the glans is dark 
red, the same as the prepuce ; secretion of humor behind 
the corona glandis ; tensive pain in the spermatic cord 
when standing, and contraction of the scrotum, with sense 
of pressure in the testicles, a sort of dragging swelling 
of the prostate gland ; painless discharge of mucus from 
the urethra. 



INDICATIONS OF THE MEDICINES. 209 

Cantharis. Pains in the region of the kidneys, ex- 
tending into the abdomen, with extreme pain during uri- 
nation ; cutting, tearing, and contractive pains along the 
ureters ; pressure, stinging, and tearing pain in the neck 
of the bladder; heat and burning in the bladder; violent 
cutting in the urethra, causing one to bend double ; con- 
stant violent desire to urinate, with difficult or scanty 
emission, which is often tinged with blood, or mixed 
with tenacious mucus, attended with cutting ; violent 
strangury, with pain in the back, and scanty, or some- 
times profuse discharge ; the urine is either white, red, 
or reddish, turbid like loam water, with white sediment, 
full of mucus, or jelly-like, or mixed with sand or clots 
of blood. During micturition, dysuria, burning, biting, 
cutting, or burning, jerking pain ; after micturition, 
burning and tingling in the urethra. Discharge of dirty, 
purulent, or yellow fluid from the urethra, often mixed 
with blood, and sometimes accompanied by chordee and 
painful erections ; violent priapism, or frightful satyriasis, 
with excessive pains, continuing nearly the whole night. 
Inflammation of the penis ; itching, burning, and heat 
of the sexual organs ; burning in the region of the excre- 
tory ducts of the seminal vessels. Drawing pains in the 
spermatic cord when urinating ; swelling of the scrotum, 
penis, and fra^num. 

Capsicum. Spasmodic contraction of the neck of the 
bladder, with cutting pain; the urine is discharged in 
drops, with burning in the orifice of the urethra, and 
depositing a white or filamentous sediment ; continual 
pressing and prickling in the glans ; drawing pain in the 
spermatic cord, and crampy pain in the testicle during 
emission of urine and some time after ; purulent discharge 
18* 



210 CHARACTEKISTIC EFFECTS AND 

from the urethra ; atrophy of the testicles, extinction of 
the sexual instinct, falling off of the beard, and weakness 
of sight. 

Carbo vegetabiliso Weakness, such as is caused by 
the loss of animal fluids, with anguish, irritability, ten- 
dency to start, and peevishness ; bluish color of skin, 
with coldness and chilliness, and attended with anguish 
or palpitation of the heart ; burning and discharge of 
ichor from ulcerations; |feat flatulence and distention 
of the stomach ; urine dark red, as if mixed with blood, 
and depositing gravel or a red sediment ; sometimes, 
however, it is thick and milky ; tearing and drawing 
pains in the urethra, and painful jerking and burning in 
the urethra when urinating ; frequent nocturnal pollu- 
tions, which violently depress the nervous energy. 

Causticum. Itching of the glans and inner surface of 
the prepuce, which is covered with vesicles, changing to 
suppurating ulcers ; nocturnal emissions, producing great 
dizziness the next day ; urine depositing a yeasty sedi- 
ment, or containing mucus. Frequent and increased 
micturition, with retarded emission of the last drops; 
the urine passes so easily as not to excite attention, and 
is lost when coughing, sneezing, or blowing the nose ; 
involuntary discharge of urine when asleep; — great 
weakness and loss of memory, or absence of mind ; 
anxious solicitude about everything that happens ; ex- 
cessive physical depression and failing of strength. 

Chamomilla. Soreness of the border of the prepuce, 
and itching, stinging pain of its margin ; burning in the 
vagina, with yellow or watery acrid discharge; tearing, 
drawing pains in the back, with contractive sensation in 
the spine, and painful stiffness in the loins ; the sexual 



INDICATIONS OF THE MEDICINES. 211 

desire is very excited, and accompanied with nocturnal 
emissions. 

Cinchona. Great debility, and tendency to passive 
haemorrhages and decomposition of the organic tissues, 
and consequent degeneration into a bad type of various 
diseases. In such cases the following symptoms are 
generally present : excessive sensitiveness of the whole 
nervous system, debility, exhaustion, and intolerance of 
noise ; extreme anxiety and apprehensiveness ; hypochon- 
dria ; singing and roaring in the ears ; paleness of the 
countenance ; swoons ; perspiration induced after the 
slightest exercise ; restless sleep, disturbed by frightful 
fancies and dreams ; loss of appetite, with bitter taste in 
the mouth ; hardness and distention of the abdomen, 
indigestion, jaundice, and diarrhoea ; scanty urine, of a 
greenish-yellow, with brick-dust sediment, or pale urine, 
depositing a loose, dingy-yellow sediment. Itching of 
the glans and stinging of the frsenum, with darting pain 
between the glans and prepuce ; drawing pains in the 
testicles ; swelling of the testicles and spermatic cord ; 
hydrocele, accompanied with tearing and drawing pains ; 
nocturnal emissions, producing great debility. 

Cinnabaris. Soreness in the urethra during micturi- 
tion ; burning, stinging, itching, with small red spots on 
the glans ; painful itching behind the corona glandis, 
with exudation of fetid pus ; redness, soreness, and 
swelling of the prepuce, with itching pain ; warts on the 
prepuce, which bleed when touched. 

Clematis erecta. Inveterate eruptions on the skin ; 
scaly eruptions, with yellowish corrosive ichor; — long- 
lasting contraction and Constriction of the urethra, the 
urine can only be passed in drops, and the stream is 



212 CHARACTERISTIC EFFECTS AND 

frequently interrupted ; frequent micturition, but little at 
a time ; emission of puriform matter, with burning at the 
commencement of urination, with painful drawing in the 
spermatic cord, extending into the abdomen ; the testes 
feel painful, as if bruised, when touched, accompanied 
with drawing and stretching, and are often swollen and 
indurated ; violent erections, with drawing pains in the 
spermatic cord, and stitches in the urethra, lasting sev- 
eral hours. 

Cocculus. Sadness, anxiety, and tendency to start ; 
restlessness at night; pressive headache, especially in 
the forehead ; aversion to food, and bitter eructations, 
with nausea and sinking at the stomach. Frequent de- 
sire to urinate, and emission of urine at short intervals, 
the pressure upon the bladder being constantly renewed ; 
stinging pain in the margin of the prepuce ; violent pains 
in the testicles, as if bruised ; nightly nocturnal pollu- 
tions ; paralytic pain in the small of the back, with spas- 
modic drawing across the hips, and hindering walking ; 
drawing, tearing, or boring pains in the back. 

Colchicum. Increased secretion of urine, with urging ; 
it is either brown, blackish, or of a light yellow color, 
and turbid ; when heated, it deposits a quantity of albu- 
men ; occasionally it burns like fire, and passes off con- 
tinually. 

Colocynthis. Urine of an insupportable odor, which 
becomes viscid, like white of egg 7 on standing, or urine 
of a pale flesh color, with a light brown, flocculent, 
transparent sediment, encrusting the utensil with small, 
red, hard crystals, which are detached with difficulty; 
retraction of the prepuce behind the glans during sleep ; 
frequent erections. 



INDICATIONS OF THE MEDICINES. 213 

Conium maculatum. Urgent desire to urinate, and 
wetting the bed at night, with burning during the act. 
Discharge of pus from the urethra ; itching of the penis, 
glans, and prepuce, which latter is also inflamed. 
Pinching, tearing, and drawing in the testicles ; swelling 
of the testicles. 

Copaibae balsamum. Excessive irritation of the blad- 
der ; inflammation, swelling, and dilatation of the orifice 
of the urethra, with pulsative pain through the penis. 
Itching, burning, biting, and pain, as from soreness in 
the urethra, before and after micturition. Foaming 
urine, of a greenish turbid color, and smelling of violets. 
Burning and sensation of dryness in the region of the 
prostate gland and bladder. Induration of the prostate 
gland, with great pain on urinating ; swelling and indu- 
ration of the testicles ; yellow, purulent discharge from 
the urethra. 

Cubebae. Increased secretion of urine, which is dark 
and foaming, and having a peculiar smell ; dark reddish 
discharge from the urethra. Orchitis, and sensation of 
pressure and heaviness in the pelvis. 

Digitalis purpurea. Continual desire to urinate, with 
excessive discharge of urine day and night, producing 
great exhaustion. Involuntary emission of urine ; con- 
tractive pain in the bladder during urination, which is 
very difficult ; the urine is either light yellow, or dark, 
becoming still more red and turbid after standing ; con- 
tusive pains in the right testicle ; the scrotum appears 
as if filled with water. Irritation of the sexual organs, 
with painful erections. 

Dulcamara. Urine turbid, white and fetid, or deposit- 
ing at times a red sediment ; or urine containing whitish 



214 CHARACTERISTIC EFFECTS AND 

mucus, attended with difficulty of passing water ; thick- 
ening of the bladder from previous inflammation. 

Ferri sulphas. Mucous discharge from the urethra, 
dependent on atony of the vessels ; nocturnal emissions. 
Constant erections; bright red urine, depositing crystals 
of the same color. 

Graphite. Swelling of the eyelids, and redness of the 
conjunctiva, with intolerance of light, and fiery zigzag 
appearances around and outside the line of vision, in the 
evenings. Thin stream of urine, as if the urethra were 
too narrow ; the urine is turbid, of a dark color, and de- 
posits a reddish or sometimes a white sediment ; swelling 
and induration of the right testicle, with sticking pain ; 
darting in the left spermatic cord ; obstinate ulcerations ; 
deficient circulation, chilliness, weariness, lassitude, lazi- 
ness, great dejection of spirits. 

[Guaco, Mikania Guaco. Turchetti states, that Guaco 
locally applied, destroys the specific property of pus from 
a chancre ; and prevents the production of a second 
chancre by inoculation. He also claims for it positive 
curative powers in Syphilis. 

Schmidt's Jahrbuch, Bd. 101, p. 168, quoted by C. Dun- 
ham, M. D., Am. Horn. Rev. Vol. Ill, p. 425.] 

Helleborus niger. Paralysis of the bladder ; painful 
emission of small quantities of urine, which is dark ; 
itching and fine stitches in the top of the glans ; dropsy 
of the scrotum ; general swelling of the lower limbs, par- 
ticularly after suppressed eruptions. 

Hepar Sulphuris. Salivation, ulceration of the mouth, 
great nervousness, swelling or inflammation of the bones, 



INDICATIONS OF THE MEDICINES. 215 

suspicious eruptions, and other symptoms traceable to the 
action of mercury. Enlargement and suppuration of in- 
durated glands, with discharge of pus , scurfy forma- 
tions, without pain, on the skin ; falling off of the hair ; 
urine flocculent and turbid, depositing a white sediment ; 
greasy pellicle on the urine, glistening with various colors ; 
blood-red urine ; the last drops are mixed with blood ; 
sharp burning urine, corroding the internal surface of the 
prepuce, and causing ulceration ; itching of the glans and 
prepuce ; ulcers on the prepuce, resembling chancre ; 
discharge of mucus from the urethra. 

Hyoscyamus niger. Retention of urine, with pressure 
in the bladder ; difficult micturition, the urine being 
yellow, and even turbid, depositing a grayish-white sedi- 
ment ; paralysis of the bladder; involuntary emission of 
urine. 

Ignatia amara. Lemon-colored urine, with w r hite sedi- 
ment ; turbid urine ; painful pressure, w T ith a sensation 
of scraping in the region of the neck of the bladder; 
smarting itching of the glans, and the inner surface of 
the prepuce ; soreness and ulcerative pain, with itching 
in the margin of the prepuce ; severe strangulating sen- 
sation, or pressure in the testicles ; swelling of the scro- 
tum in the evening ; violent crampy pressing in the re- 
gion of the uterus, with purulent discharge. 

lodium. Chancre-like sores, a portion of which be- 
comes elevated, whilst the remainder deepens ; swelling 
and indurations of the glands ; wasting of the glands ; 
dark, turbid, yellow, green, or milky urine, having an 
ammoniacal smell, and corroding the urethra, with itch- 
ing, smarting, and intensely painful cutting in the 
urethra; great irritation of the nervous system, with 



216 CHARACTERISTIC EFFECTS AND 

uneasiness in all the limbs, and increased sensibility of 
the whole body ; trembling of the limbs, with vacillating 
gait, and great weakness. 

[Jacaranda Caroba. The orifice of the urethra looks 
like two small inflamed lips, itching when touched. Heat 
and pain of the penis. Discharge of a yellowish-white 
liquid from the prepuce. Pain in the prepuce, as if a small 
bundle of fibres were seized. The prepuce cannot be 
drawn back, (phimosis.) Suppuration between the glans 
and prepuce. Acute pain in left testicle when walking. 
Heat and swelling of the scrotum. Slight pinching in 
the prepuce. Itching pimple at the glans, suppurating 
like a chancre, and leaving a red spot when dry Sup- 
pression of the sexual desire. Painful erections during 
a swelling of the prepuce. The contact of the urine 
causes tearing pains, which affect the whole organism. 
Itching and pricking at the margin of the prepuce. 
Rheumatic pains. Sleeplessness. Frightful dreams. 
Malaise. Nausea. Debility. 

See Mure's Materia Medica ; and Lippe's Text-book 
of Materia Medica.~\ 

Kali carbonas. Inflammation of the eyes, with burning 
and biting sensation, and swelling of the eyelids ; tear- 
ing, with pressure in the interior of the eye; sharp tearing 
in the orbit ; blue and green spots before the eyes. 
Pinching in the left testicle, with dragging pain and 
swelling ; the scrotum feels as if bruised. Pale greenish 
urine, or dark yellow urine, or resembling loam-water, 
with copious sediment, and emitted with difficulty. Vio- 
lent tearing, as if in the marrow of the bones ; frequent 



INDICATIONS OF THE MEDICINES. 217 

weariness and depression of strength, and feeling of 
emptiness in the whole body ; the whole body feels 
heavy and broken down ; pulsation of all the arteries of 
the body ; sudden trernulousness. 

Kali iodidum. Ulceration of the bones, with adventi- 
tious growths of the soft parts, and fistulous openings ; 
inflammation of the periosteum, or interstitial distention 
of the bone ; enlargement of the glands, with incipient 
purulent infiltration of the parts ; puffy swelling of the 
mucous membrane ; interstitial deposit in the prostate 
gland, occasioning a complete retention of urine ; painful 
urging to urinate, the urine being as red as blood ; dis- 
charge of mucus from the urethra ; profuse salivation, 
with great swelling of the tongue and excessive ulcera- 
tion of the mucous membrane of the mouth ; papulous 
and herpetic eruptions on the skin. 

Kreasotum. Smarting swelling of the vagina, with 
soreness when passing urine ; corrosive itching between 
the labia and vagina, succeeded by burning and swelling 
of the labia and discharge of mucus and blood ; urine hot 
and smoking, of a dark red or chestnut color, with sedi- 
ment of a brown or sometimes white color ; great de- 
pression of spirits, weariness of the limbs, and uneasi- 
ness of the whole body ; great diminution of the vital 
energy, with lax and impoverished constitution ; dis- 
charge from the mucous surfaces ; passive haemorrhages 
(venous), with tendency to putrefaction ; fetid diarrhoea, 
and putrid character of many of the symptoms. 

Lachesis. Urine of a copper color, depositing a floccu- 

lent sediment ; discharge of mucus with the urine, which 

looks like white of egg, when it has stood some time ; — 

hard cartilaginous degeneration of the prepuce, or at- 

19 



218 CHARACTERISTIC EFFECTS AND 

tended with phimosis ; red spots on the glans and pre- 
puce ; pressing in the testicles when sitting ; — violent 
pains in the bones, preventing sleep ; ulcerations of a bad 
character, being hard, cartilaginous, of a livid or greenish- 
yellow color, and bleeding readily when touched, 

Lycopodium. Red, inflamed eyes, with profuse lach- 
rymation and burning and smarting pains ; tensive and 
bruised feeling in the eyes ; — during urination the. flow 
is suddenly interrupted, only a few drops of turbid and 
slimy urine being passed ; urine foamy, reddish-brown, 
and depositing a reddish-yellow sediment ; smarting sen- 
sation in the female urethra during urination ; jerking 
drawing in the posterior part of the urethra ; dropsical 
swelling of the genital organs ; darting sensation in the 
left testicle ; heaviness and pain in the testicles ; draw- 
ing and cutting in the glans ; excessive nocturnal emis- 
sions ; — pains in the periosteum ancLbones, with nightly 
aggravation of a drawing character ; sensation as if the 
bones contained no marrow ; — ulcers with hard, shining 
elevated edges, and copious, watery, ichorous, very fetid 
pus, and surrounded with blue, red, hard, painful areola, 
with tearing lancinating pains, which are worse at night ; 
relaxation of the body, with nervous irritation and 
tremor, the weakness often increasing after rest ; cold- 
ness and chilliness of the body ; great tendency to take 
cold; oppression of the chest and palpitation of the 
heart ; hiccough, sour eructations, frequent nausea, 
weight at the stomach, dull and stitching pain in the 
liver after eating ; hepatic spots on the chest. 

Mercurius. As this remedy is so constantly used in 
syphilitic diseases, and so much suffering has resulted 
from its indiscriminate employment, the following anti- 



INDICATIONS OF THE MEDICINES. 219 

dotes are here given, covering nearly the whole of the 
groups of symptoms that arise from its abuse : 

Acid nitric. Against violent pains in the bones; ul- 
ceration of the mucous membrane ; mercurial symptoms, 
combined with congestions and inveterate syphilis ; 
stomacace mercurialis ; scorbutic haemorrhages ; ulcera- 
tion of the mucous membrane of the mouth ; affections of 
the periosteum and bones. 

Acid phosjih. Against periostitis. 

Arnica. Against pulmonary haemorrhage. 

Artemisia. Against hydrargyrosis (mercurialization) 
combined with rheumatism and gout. 

Asafoetida. Against caries and ozaena. 

Aurum. Against cachexia and scrofula ; hypochon- 
dria ; ozaena ; induration and swelling of the testicles. 

Belladonna. Against congestion to the head ; peri- 
ostitis and ostitis ; phlegmonous (painful, tense, red, cir- 
cumscribed) inflammation of the glands. 

Carbo veg. In acute poisoning with Merc, corros., 
with threatening gangrene ; ulceration of the mucous 
membrane of the intestines, stomacace ; gangrene result- 
ing from salivation ; ulcers having a scorbutic and gan- 
grenous character, with nightly burning pains. 

Cinchona. Against excessive weakness, consequent 
on the loss of strength and humors ; excessive irritation 
of the nervous system, excessive sweats, great sensitive- 
ness of the skin to changes of temperature, and liability 
to take cold ; affections of the periosteum and bones ; 
caries. 

Conium. Against cold, indurated, glandular swellings. 

Dulcamara. Against rheumatism, great liability to 
cold; herpes and impetigo (running tetter). 



220 CHARACTERISTIC EFFECTS AND 

Ferrum. Against cachexia, ulcers, periostitis (Ferr. 
phosph.) ; hydrargyrosis, combined with torpid scrofula 
(Ferri iodidum) ; trembling of the limbs and neuralgia. 

Guaiacum. Against rheumatism and gout, or the two 
combined with hydrargyrosis. 

Iodium, Kali iodidum. These are the chief antidotes 
of mercury, especially when the lower tissues are the 
seat of the affection, assuming the forms of secondary 
or tertiary syphilis, and consisting of affections of the 
inner mucous membrane, the outer skin, the periosteum 
and bones, thickening and abnormal growths of the afore- 
said tissues ; they should, therefore, be chiefly employed 
in induration and thickening of glandular organs, of the 
testicles, liver, mesenteric, parotid, cervical, axillary, and 
inguinal glands ; salivation and gangrene arising there- 
from ; cutaneous diseases, as tubercles, ulcers, and gum- 
mata ; inflammation of the periosteum and bones, caries, 
and tophi (soft swellings on the bone). When the sys- 
tem has been saturated with mercury in the treatment 
of secondary or tertiary syphilis, Iodium will neutralize 
its effects and restore the susceptibility of the organism 
to the action of that drug. 

Kreasotum. Against scorbutic symptoms, ulceration 
of the mucous membrane of the mouth and fauces ; cuta- 
neous ulcers ; salivation. 

Lachesis. Against ulcers of the fauces ; gangrene 
from salivation. 

Lycopodium. Against ulcers of the throat and fauces ; 
affections of the bones. 

Mezereum,. Against ostitis and periostitis; chronic 
inflammation and induration of the testicles and tonsils ; 
impetigo and herpes. 



INDICATIONS OF THE MEDICINES. 221 

Natr. mur. Against scorbutic diathesis. 

Nux vomica. Against trembling of the limbs; paraly- 
sis of the optic nerve and lower limbs. 

Opium. Against excessive nervous irritability ; neu- 
ralgia ; painful salivation ; hydrargyrosis, combined with 
rheumatism; adynamic fever, with congestion of the 
brain; ulcers, attended with great pain; morbid sensi- 
bility and hydrargyrosis, with decomposition of the 
blood ; softening and puffiness of the solids and solid 
tissues, and colliquative phenomena. 

Phosphorus. Against mercurial phenomena ; neural- 
gia ; ostitis and periostitis ; paralysis. 

Sarsaparilla. Against cutaneous eruptions. 

Silicea. Ulcerations and -caries. 

Staphysagria. Hypochondria; ostitis and periostitis. 

Sulphur, Hep. sulph. In the lower forms of h}^drar- 
gyrosis, but not applicable in a perfectly developed scor- 
butic mercurial cachexia ; for iritis, cutaneous eruptions, 
and ulcers ; affections of the bones and mercurial asthma. 

Zinc sulph. Against neuralgia in plethoric individ- 
uals suffering from congestions, and sensitive individuals 
disposed to spasms. 

General Symptoms. — Greater or less affection of 
the mucous membrane, the respiratory organs, the intes- 
tinal canal, and the urinary and genital organs ; shortly 
afterwards, the skin and glandular tissues are similarly 
affected. The secretions, particularly those of the intes- 
tinal canal, mucous membrane, liver, and skin, are in- 
creased ; the excretions are more abundantly, and mor- 
bidly altered ; the mucus is cruder ; the urine turbid ; 
the alvine evacuations are darker and thinner, and 
greenish ; the exhalations from the skin are clammy, 
19* 



222 CHARACTERISTIC EFFECTS AND 

smell disagreeably, and the epidermis becomes flaccid. 
Gastric symptoms are in the meanwhile making their 
appearance ; the taste becomes impaired, the breath 
offensive, the tongue more or less coated, the appetite 
diminishes ; the patient complains of general discomfort ; 
the pulse is irritable ; the blood is of a serous, fluid con- 
sistence ; all the secretions become more liquid, and 
even the solids interstitially distended. The callus of 
bony fractures is dissolved ; the fibrous tissues, particu- 
larly the muscles, lose their tonicity; the patient feels 
weary and languid. The whole body, and more particu- 
larly the face, is bloated, and has a dingy, sallow ap- 
pearance ; the milk in the breast becomes poisonous, 
and often causes convulsions in the child. In severer 
cases the following symptoms are present : languor and 
exhaustion ; derangement of the digestive organs ; great 
flatulence; constipation, alternating with diarrhoea; sour 
eructations ; emaciation ; apathy. The hair loses its 
lustre, becomes dry, and falls off; the eyes retreat into 
their orbits, look dim and watery ; the conjunctiva is 
dingy, has a reddish tinge, with clusters of varicose 
vessels, which become closely interwoven around its 
border. The iris loses its natural color ; whether blue, 
brown, or blackish, it now looks gray and dingy; the 
face looks pale, dingy, and sallow ; the cheeks are sunken 
and flabby ; the nose becomes pointed ; the wings of the 
nose assume a greenish or bluish tinge ; the lips are 
withered and bluish (these symptoms constitute the so- 
called quicksilver physiognomy') ; the gums recede from 
the teeth, become bluish-red ; the teeth lose their enamel, 
are covered with a fibrinous coating, tarn black, become 
loose, and fall out. The mucous membrane of the fauces 



INDICATIONS OF THE MEDICINES. 223 

and mouth, which is interstitially distended, looks pale, 
bluish, and dingy ; the breath is offensive ; the lips red- 
blue ; the chin pointed and prominent ; the skin of the 
body feels flaccid, withered, and cold to the hand; the 
veins, which are swollen, shine through it. The saliva 
is tenacious ; the sweat clammy ; the urine pale and 
turbid ; the stools are watery ; the exhalations have a 
fetid smell ; mobility is diminished ; the activity of the 
mind depressed ; the patient is indifferent, apathetic, and 
frequently falls into a state of imbecility, preceded by 
weakness of memory, sight, hearing, and other senses. 

Mind and Disposition. — Paroxysms of oppressive 
anxiety, general confusion of ideas, loss of memory, 
great tendency to start, with trembling of the whole 
body ; peevishness, taciturnity, suspiciousness, with great 
irritability and quarrelsomeness. 

Head. — Violent vertigo, heaviness, and dulness ; 
weakness of intellect ; craziness ; absence of mind, and 
strange ideas crowding on the mind when employed ; 
violent headache, pressing from within outwards ; tear- 
ing headache, especially in the forehead ; painful lancina- 
tions in the left side of the forehead ; jerking, drawing, 
and pinching pains in the right temple, extending to the 
back part of the head ; burning itching of the forehead ; 
boring in the occiput ; burning in the region of the left 
temple. 

Eyes. — Inflammation of the conjunctiva, the eyelids 
swollen and red ; the canthi are excoriated, and attended 
with smarting pain ; the margins of the lids are burning 
and itching, are agglutinated in the morning after sleep, 
and secrete a quantity of gum ; pinky redness of the 
eyes (sclerotitis), with itching, smarting, and burning 



224 CHARACTERISTIC EFFECTS AND 

pain ; secretion of mucus, and afterwards pus, from the 
inflamed and swollen conjunctiva ; injection of the vessels 
of the sclerotic, forming a circular ring round the cornea, 
with discoloration of the iris, with tendency to contrac- 
tion of the pupil ; burning aching in* the bottom of the 
eye, with great intolerance of light; constant lachryma- 
tion ; a variety of colors, sparks, and fiery rings before 
the eyes ; ulceration of the cornea, afterwards terminating 
in specks (nebulae), or denser white masses (albugo and 
leucoma). Mistiness before the eyes, sometimes van- 
ishing of the sight for a few moments. 

Nose. — Swelling of the whole nose, especially of the 
left side, with interstitial distention at its root ; frequent 
sneezing and profuse fluent coryza, which is very acrid, 
and afterwards changing to pus ; putrid smell in the nose. 

Mouth. — Bluish redness and interstitial distention of 
the mucous membrane of the mouth, which forms along 
the line of contact with the teeth an arch of yellow color, 
receding from the teeth together with the gums, and 
bleeding readily on that account, causing the teeth to 
become loose, and sometimes to fall out ; swelling of the 
lymphatic glands, the cheeks, and tongue, w T hich last 
frequently attains such a size as to fill, the whole cavity 
of the mouth, causing the patient to open his mouth, in 
order to give the tongue more space ; swelling of the 
fauces and tonsils, involving the Eustachian tube, and 
diminishing the hearing ; violent burning pains attend 
these symptoms, and deglutition is very difficult. Cada- 
verous smell from the mouth on expiration; frequent 
accumulation of saliva in the mouth, inducing frequent 
spitting; these symptoms increase, till the saliva runs 
uninterruptedly from the mouth, which is constantly 



INDICATIONS OF THE MEDICINES. 225 

open, the patients being prevented from spitting by the 
swelling of the parts. The mucous membrane of the 
mouth and cheeks breaks down where it touches the 
teeth, the parts bleed, and flat, painful ulcers make their 
appearance; the teeth are covered with thick putrid- 
smelling sordes, corroding the enamel, after which the 
teeth frequently turn black ; the saliva feels hot, is very 
tenacious, so that it can be drawn into threads, and 
looks glairy or milky, and sometimes yellowish, and 
very rarely greenish or reddish ; to the patient it tastes 
either sour, salt, sweetish, flat, bitter and putrid, metallic, 
generally acrid, on which account it corrodes the mucous 
membrane, occasioning cough, vomiting, &c. The quan- 
tity of saliva varies from two or three pints to sixteen 
pints in the twenty-four hours. 

Pharynx and (Esophagus. — Dryness in the posterior 
part of the fauces, unrelieved by drinking; at the same 
time the voice becomes somewhat husky, peculiarly 
rough, with feeling as if the entrance of the windpipe 
were closed with swelling. There is now drawing pres- 
sure in the posterior part of the pharynx, with stoppage 
of the nose, consequent upon the supervening dryness of 
the Schneiderian membrane, which the patients attempt 
to relieve by expelling the air through the nostrils with 
closed mouths ; the air thus expelled feels rough ; when 
talking there is pain, which is partly stinging, partly 
pressive, and increases to a burning if the talking is con- 
tinued ; this irritation of the mucous membrane gradually 
involves the fauces, the upper part of the larynx, and the 
Eustachian tube as far as the internal ear ; in many 
cases the membrane looks dry and corroded, the patients 
being compelled to hawk frequently ; the tonsils, velum 



226 CHARACTERISTIC EFFECTS AND 

palati, uvula, and particularly the back part of the fauces, 
exhibit a redness, which varies from dark-red to bluish 
red, with somewhat darker spots here and there, with 
yellowish elevations, the size of half a pea, in those spots; 
these are slightly swollen mucous glands. The vessels 
of the mucous membrane now become injected, the uvula 
in particular becoming surrounded with a perfect network 
of vessels. Over other parts of the mouth single vessels 
are seen spreading in various directions, like coarse 
threads, generally from a$&ve downwards, of a violet- 
bluish color, and surrounded by clusters of other varicose 
vessels ; on the mucous membrane of the cheeks, or on 
the inner side of the lips, a vesicle is seen, from the size 
of a lentil to that of a pea ; it is formed by the delicate 
epithelium of the mucous membrane, and is of a beautiful 
pale-yellow color ; when opened, it discharges a clear, 
tasteless lymph, and the wound rapidly heals. 

Gastric Symptoms. — Bitter putrid eructations, with 
heartburn, frequent hiccough, nausea, and inclination to 
vomit ; excessive appetite and hunger, but there is total 
want of relish for anything ; metallic or coppery taste in 
the mouth, with very bitter taste, especially after drink- 
ing coffee ; constrictive tearing pain in the stomach, with 
burning pain, and intensely painful aching oppression at 
the stomach from eating even the lightest kind of food. 
Painful sensitiveness of the region of the liver to contact, 
with burning tension and feeling of fulness ; pushing and 
pressing from within outwards in the liver; in severe 
cases, complete jaundice, or induration of the liver. 

Stool. — Violent diarrhoea, with discharge of green, 
slimy, acrid stools, or dark green, bilious, frothy stools, 
with violent urging ; or dysenteric stools, consisting of 



INDICATIONS OF THE MEDICINES 227 

blood, and mucus, or slime ; yellow or clayish stools, 
indicating the total absence of bile ; violent burning, 
biting, cutting, or pinching pains in the anus ; great 
anxiety and trembling before stool, succeeded by bitter, 
rancid eructations, and some heartburn. 

Urinary Organs. — Frequent desire to urinate, with 
scanty discharge of urine, the stream being extremely 
feeble ; urine dark reddish brown, and very turbid, even 
on leaving the urethra ; or it deposits whitish flocks, or 
looks as if stirred with flour ; sometimes it is mixed with 
mucus and pus, depositing a thick sediment, or smells 
soar ; burning and smarting, or cutting pains accompany 
the act of micturition. 

Sexual Organs. — Itching, stinging, and pricking in 
the glans, with swelling of the orifice of the urethra, with 
suppuration between the glans and prepuce, which feels 
red and hot, and is very painful when touched, or when 
walking ; there is voluptuous itching on the internal sur- 
face of the prepuce, with cracks and fissures, and a fine 
eruption ; vesicles on the fore part and sides of the glans, 
penetrating into the part and spreading, discharging a 
fluid, and then disappearing ; small red vesicles, chang- 
ing to ulcers, which burst and discharge a yellowish- 
white, staining, strong-smelling matter ; they are round, 
the edges, which look like raw flesh, overlap the ulcers, 
the base of which is covered with a cheesy lining. Draw- 
ing in the spermatic cord, and pressure in the testicles, 
which are swollen and indurated. Biting sensation in 
the female urethra during urination, with itching of the 
labia. Inflammatory swelling of the vagina, with dis- 
charge of flocks, mucus, and pus, of the size of hazel- 
nuts ; discharge of greenish, purulent, acrid fluid from 
the vagina. 



228 CHARACTERISTIC EFFECTS AND 

Fever. — Restlessness, languor, and worn-out feeling ; 
dryness of the mouth, tensive and aching pain in the 
head, particularly at the back ; loss of appetite, rumbling 
in the intestines, disgusting eructations, inclination to 
vomit, and hot, dry skin ; little increase of thirst ; con- 
stipation, with pressure in the precordial region ; sleep 
now becomes restless, with heavy, fanciful dreams ; urine 
fiery red, and pulse irritable, full, and quick ; the dry- 
ness in the mouth is changed to burning, the gums are 
dark red, and recede somewhat from the teeth, the tongue 
commences to swell, and the tensive aching pain in the 
occiput extends to the nape of the neck, and even the re- 
gion of the scapulae, inducing stiffness of the neck. The 
patient smells unpleasantly, and has a coppery, metallic 
taste in the mouth ; he moans continually, and suffers 
from great oppression and anguish ; the chills also 
alternate w T ith flushes of heat; the- eyes become red, 
glassy, and watery ; an aching pain commences to rage 
in the forehead ; towards the root of the nose, which is 
dry and obstructed, the cheeks are hot, deglutition is 
impeded by a tensive burning and stinging pain, the 
submaxillary and parotid glands are swollen, a drawing 
and tearing is experienced in the ears, the teeth become 
very sensitive, the root of the tongue is coated with a 
whitish mucus, breathing becomes more and more anxious, 
the oppression increases, the pulse quick and undulating. 
These phenomena characterize the acme of the fever, and 
disappear by violent critical discharges, such as saliva- 
tion, profuse emission of urine, excessive perspiration, or 
the breaking out of an eruption. Sometimes an opposite 
state occurs ; the countenance looks livid, with blue 
margins around the dim and glassy eyes ; the head feels 



INDICATIONS OF THE MEDICINES. 229 

giddy ; the nose, face, and extremities are cold, but to- 
wards evening, slight chills, with flushes of heat, are 
present ; there is now oppression, moaning, anguish, and 
pressure in the precordia ; the sleep is heavy and rest- 
less, the pulse quick and small, the urine clear and yel- 
lowish, and there is slight constipation ; this lasts a few 
days, and then increases in violence ; there is complete 
apathy, the face pale as death, the body feels cool, the 
pulse somewhat fuller, and the patient lies in bed listless 
and weak ; at this stage there is a sudden change ; in- 
clination to vomit, or vomiting of a greenish tenacious 
substance, oppression at the chest, the breathing difficult, 
the eyes wander, and the pulse frequently intermittent ; 
there is slight delirium, even in the day, the skin and 
tongue are dry, the latter being clean ; death now gen- 
erally ensues from effusion on the brain. When perspi- 
ration supervenes upon any of the preceding symptoms, 
it is always extremely profuse, and has a clammy, pecu- 
liarly fetid smell, never to be forgotten ; it is very exhaust- 
ing and debilitating, and leaves a great disposition to 
sweat, even after taking warm drinks ; immediately it 
has appeared, the abnormal symptoms vanish, and vio- 
lent raging thirst, caused by the perspiration, sets in. 

Skin. — Mercurial miliaria is always preceded by 
symptoms of marked irritation of the nervous system, 
and a slow, torpid, febrile paroxysm : the eruption on 
making its appearance is accompanied by cessation of the 
restlessness and anxiety of the patient ; the rash breaks 
out in patches, every day, attended by the same precur- 
sory symptoms, till the eruption is complete over the 
whole body. The vesicles are white and close together ; 
the fever returns every evening, the pulse is small, soft, 
20 



230 CHARACTERISTIC EFFECTS AND 

easily compressible, not very quick ; the urine is pale, 
the skin drenched in perspiration, which has a flat, but 
not sourish smell ; nervous symptoms, such as sleepless- 
ness, slight delirium, and even convulsions, supervene ; 
single portions of the eruption disappear, the others re- 
maining ; whilst these symptoms decrease and increase 
continually, the typhoid phenomena augment, the pulse 
intermits, the rash recedes from the skin, which becomes 
diy, and the patient dies comatose. This eruption is only 
met with in extremely severe cases. — Mercurial eczema. 
Troublesome itching, with gradually supervening rose 
color of the skin, which is traversed by a few red streaks, 
which on inspection prove to be sound skin. The red- 
ness arises from an assemblage of larger or smaller spots, 
and these impart a sensation of burning heat to the 
finger ; this redness disappears on pressure, but returns 
directly the pressure is removed ; after twelve hours or 
so, slight elevations are discovered with the finger, which, 
viewed through the microscope, prove to be vesicles, 
crowded together ; on the second day they become more 
elevated, and are perceptible to the naked eye, when 
viewed obliquely, and are filled with yellow lymph ; 
after this the itching abates. On the third day, they 
become depressed; on the fourth day, 'they desiccate ; 
on the fifth day, the skin scales off ; in severe cases the 
itching increases to a burning sensation, the skin assumes 
a dark-red tinge, the vesicles increase to the size of pus- 
tules, and the patient is attacked with feverish chills, 
even before the vesicles make their appearance ; the 
eyes are slightly reddened and watery, the nose stopped, 
the mouth and pharynx are dry, there is constipation, 
scanty red urine, and the pulse rather hard, quick, and 



INDICATIONS OF THE MEDICINES. 231 

small ; there is also great restlessness and uneasiness ; a 
few bilious evacuations now occur in the course of the 
day, the skin, which was burning hot, now begins to 
perspire, and the skin peels off in patches where the 
eruption was situated. — Mercurial herpes of the prepuce. 
Internal redness at one spot on the inner surface of the 
prepuce, attended with considerable itching ; the redness 
is not circumscribed, but is diffused gradually into the 
surrounding skin ; on the second day several vesicles are 
seen rising slowly, of a pale red, bordering on white, of 
the size of a millet-seed, and transparent ; they spread 
rapidly, till they coalesce, when they become darker and 
purulent; they burst on the third day, and then exhibit 
a roundish excoriation, with a slightly elevated border ; 
the base is yellowish white, secreting a good deal of pus ; 
the continued redness of the mucous membrane, and the 
recently formed ulcers, occasion an itching, burning sen- 
sation, increased by the application of cold water; the 
discharge continues four or five days, after which the 
ulcers assume a whitish appearance, disappearing in a 
day or two. A beautiful bright-red cuticle makes its 
appearance in the place of the former ulcers, on a level 
with the sound mucous membrane. — Mercurial impetigo. 
Dark red spots, of various sizes, appearing in the region 
of the sexual organs, and then on the chest ; they are 
unequal, and run into one another, which gives them the 
appearance of a map ; they do not seem to be raised 
above the skin, but itch considerably ; some months 
after their first appearance they become somewhat 
browner, and rash-like vesicles make their appearance on 
the spots ; they become depressed in their centre on the 
fifth, and scale off on the ninth day, the itching continu- 



232 CHARACTERISTIC EFFECTS AND 

ing. At first the vesicles are only seen on the sternum, 
after which they spread over the whole chest, arms, 
calves, and inner surface of the thighs; the vesicles 
break out repeatedly ; sometimes some of them burst, 
leaving small indented ulcers, which run into one another, 
and secrete a brownish-yellow, tenacious, and viscid pus, 
which dries up into a crust, under which the process of 
suppuration continues ; the upper parts of this scurf 
gradually assume a whitish-gray appearance, and scale 
off; this scaling off and forming anew of the scurf is 
going on constantly, as soon as the ulcers are once 
formed. After the eruption has lasted two or three 
months, the other parts of the skin, which had, so far, 
remained free, become affected ; the skin becomes rough, 
dry, parched, and covered with small bran-like scales; 
these scales accumulate principally on those parts of the 
skin that are covered with hair, which frequently falls 
off in patches, along with the scales ; these symptoms 
are accompanied with other mercurial symptoms in- 
volving the gastric and urinary organs, and the mucous 
tissues. — Mercurial ulcers. Interstitial distention of the 
mucous membrane, which becomes bluish-red in one or 
more places ; these spots soon become whitish, and the 
dissolution of the part becomes evident ; in a few hours 
the whitish-gray substance changes to a fetid ichor, flows 
off, and exhibits an indented flat circular ulcer, with 
almost spongy base, and indented edge ; the ichor is 
profusely discharged, the ulcer spreads rapidly in extent, 
but not in depth, and is very painful ; in severe cases it 
assumes a dirty, putrid appearance, and becomes rapidly 
phagedenic. Blood is now discharged from the ulcers, 
not vigorously, but oozing as from a sponge, which 



INDICATION'S OF THE MEDICINES. 233 

evinces a state of great debility. — Mercurial, combined 
with syphilitic ulceration. The parts around the chancre 
are somewhat reddened, which changes in a few hours 
to a light bluish, violet color; the border of the chancre 
swells somewhat, becomes raised, and looks like the sur- 
rounding parts ; very small and fine vessels are now seen 
running from the edge to the ulcerated surface, the base 
of which was lardaceous previously, and discharged a 
thickish pus, but now of a dirty, shaggy appearance, 
secreting a thin acrid fluid. If red, healthy granulations 
had existed, they change to a dirty yellowish brown; 
blood is discharged from the ulcer, which spreads rapidly 
in breadth and depth, destroying the surrounding soft 
parts ; the sore becomes extremely painful as soon as the 
neighboring parts turn red. 

Nerves. — Along the track of a motor nerve, drawing 
tearing pains are experienced, not generally fixed, but 
wandering along its course. If the affection lasts any 
length of time, it passes to other branches, particularly 
when the weather is variable ; the pain has distinct but 
irregular intermissions, and recurs after exertion, or 
heating, or from a current of cool air; wet weather is 
very distressing in such cases ; the nights are generally 
quiet ; violent tearing pains in the tibia and face, pro- 
ceeding, in the latter case, from the teeth, and extending 
to the temple and side of the head, and depriving the 
patient of rest. Trembling of the limbs, so violent that 
the patient is unable to talk, walk, or eat; he has to be 
dressed by others; violent trembling, first of the hands, 
then of the whole body ; he is constantly convulsed, and 
cannot raise his hands to his mouth without striking 
himself; he even swallow T s convulsively, with danger of 
20* 



234 CHARACTERISTIC EFFECTS AND 

suffocation ; sometimes there is slight drawing in the 
arm along the track of the nerves ; it may be likewise 
felt in the lower limbs, occasioning a tensive feeling of 
the muscles, when walking ; afterwards, involuntary 
motion of single muscles supervenes; the drawing now 
changes to trembling of the affected limbs, which, at 
first, is slight, but afterwards increases to an intolerable 
degree ; at a later period, single vibrations of the pectoral 
muscles, and particularly of the neck, are perceived, 
causing the head to totter, and inducing either a stutter- 
ing speech, or an occasional interruption of it, by a con- 
vulsive contraction of the parts ; sometimes these spas- 
modic movements extend to the diaphragm, inducing 
constant hiccough, and to the tongue, producing tremu- 
lous and indistinct speech. On attempting to raise the 
foot, the tremor recommences, and the foot descends 
again to the ground. Sometimes the patient is, indeed, 
free from trembling and spasm ; but any part of the body 
that he attempts to move is at once affected by them ; 
the muscles of the left side also suffer more than the 
right ; consciousness is never disturbed. 

Bones. — Slight tension and drawing in the bones, 
which are only covered by cellular tissue and integument, 
after sunset, and which recurs for some days, about the 
same time ; on the fourth or fifth day the pain becomes 
gnawing, and at one spot only ; this symptom increases, 
depriving the patient of sleep and rest, till towards 
morning ; there is no abnormal appearance to be observed, 
but on touching the part there is pain evinced, of a partly 
sticking, partly aching character ; the periosteum now 
becomes interstitially distended, and exudes an albumi- 
nous substance, where the gnawing pain is experienced ; 



INDICATIONS OF THE MEDICINES. 235 

this exudation gradually increases, producing an adhesion 
between the periosteum and the cellular tissue, and con- 
verts both of them into a grayish-white, homogeneous, 
somewhat doughy, but rather hard-feeling substance ; 
the swelling thus formed varies in size from that of a 
hazel-nut to that of a hen's egg, but in some cases ex- 
tends the whole length of the periosteum; these swellings 
are generally termed gummata ; the color of the skin on 
the outside remains unchanged. As soon as the swelling 
commences to form, the pains increase in intensity, the 
intermissions become shorter, and finally disappear; the 
nervous system suffers from the pain, and sleepless 
nights, failing of the appetite, and hectic fever, often 
supervene. Sometimes the patient complains of a wan- 
dering, drawing pain in the interior of the bones ; this 
shortly becomes fixed to one spot, increases in violence, 
becomes gnawing and boring, and occasions indescribable 
sufferings, depriving him of sleep; after some weeks, the 
bone begins to swell, feels hard and bony, showing that 
it arises from interstitial distention. The pains, wiiich 
are now frightful, are characterized by intermissions, 
aggravated by the warmth of the bed, decrease in a 
cooler temperature, and are most violent during a change 
of weather. Caries of the bone may result, the bone 
becoming so friable that it may be crushed with the 
fingers. 

Mezereum. Dark urine, becoming turbid, and de- 
positing loose flocculi, and a reddish sediment, and occa- 
sionally blood ; burning in the fore part of the glans 
during urination, and stinging, pricking in the urethra; 
crampy sensation in the bladder, and discharge of mucus 
from the urethra. Tearing in the penis, with jerks and 



236 CHARACTERISTIC EFFECTS AND 

darting in the glans ; fine pricking stitches in various 
parts of the glans; dark-red inflammation of the internal 
surface of the prepuce, without swelling, with violent 
itching and soreness in the evening; painless swelling 
of the scrotum ; discharge of mucus from the vagina. 
Tearing, boring, smarting, and burning in various bones ; 
violent corrosive sensation and throbbing in contused 
wounds ; itching redness, drawing, and stitches in ul- 
cerated wounds. 

[ Jft skin-diseases : Itching, occurring in the evening, 
when in bed ; aggravated and changing to burning by 
touch, or by scratching. Sensitiveness to touch.] 

Millefolium. Congestion of blood to the urinary 
organs, with sanguineous discharges, particularly haeina- 
turia. 

Moschus. Scanty and thick urine, like yeast; violent 
sexual excitement, even in old people. 

Natri murias. Frequent or involuntary emission of 
urine, which deposits a loamy or brick-dust sediment ; 
burning and biting in the urethra when urinating; dis- 
charge of thin mucus, leaving stiff translucent spots on 
the linen. Discharge of yellow pus from the urethra, 
but without pain during micturition ; strong and offen- 
sive smell of the genital organs, with intolerable smarting 
itching ; itching and redness of the tip of the glans, with 
great humidity of the part. Pinching and drawing 
aching in the testicles ; dryness of the vagina. 

Nux vomica. Pale urine, containing thick, white, 
purulent matter, or tenacious mucus, with violently 
burning pains. Urine depositing a red brick-dust sedi- 
ment ; pain in the neck of the bladder, of a burning or 



INDICATIONS OF THE MEDICINES. 237 

tearing nature ; burning in the urethra, and soreness at 
its orifice ; spasmodic contraction of the urethra, with 
retention or difficult emission of urine ; paralysis of the 
bladder ; the urine coming away as soon as formed, 
drop by drop ; urine mixed with blood. Sore pain at 
the tip of the glans, which itches and smarts, and burns 
and itches at its posterior part ; smarting itching of the 
inner surface of the prepuce, and soreness of its margin, 
particularly towards evening. Heat, stitches, and con- 
strictive pain in the testicles, which are swollen, indu- 
rated, and drawn up, with sticking and spasmodic feeling 
in the spermatic cord ; nocturnal emissions, followed by 
coldness of the feet, and great languor ; great nervous 
prostration and debility, with noises in the head, rest- 
lessness, and disturbed sleep ; sleepiness after eating ; 
disinclination to work, which quickly wearies ; trembling 
of the limbs, attended with palpitation of the heart, acute 
nervous sensibility to light, noise, or even the least 
trifle; ill humor and peevishness; general derangement 
of digestion, with foul taste, costiveness, nausea, and 
retching; feeling of constriction round the waist; mo- 
tions large, hard, and lumpy, or consisting of slime and 
froth ; shooting pains through the body ; weariness and 
dragging pains in the back ; complexion sallow and livid, 
with blue circles round the eyes ; coldness and chilliness, 
and tendency to take cold. 

[Occimum canum. Turbid urine, depositing a white 
and albuminous sediment. Burning during micturition. 
Urine of a saffron color. Diarrhoea, several attacks a 
day. Crampy pain in the kidneys. Renal colic, with violent 
vomiting every fifteen minutes ; one wrings one J s hands, 



238 CHARACTERISTIC EFFECTS AND 

and moans and cries all the time. Red urine (or bloody,) 
with brick-dust sediment after the attack ; (or discharge 

OF LARGE QUANTITIES OF BLOOD WITH THE URINE ; CUra- 

tive, reported by Dr. Lippe.) Thick, purulent urine, with 
intolerable smell of musk. (Right kidney affected, like 
Kali carb. L.) Swelling of inguinal glands. Heat, 
swelling, and excessive sensibility of the left testicle. See 
Mure's Materia Medica, p. 215, and Lippe's Text-Book 
of Materia Medica. - ] 

Opium. Suppression of urine, or, on the contrary, 
excitation of the renal vessels, with increased flow of 
urine ; feeling of closure of the urethra, and difficulty, or 
spontaneous interruption in urinating. Lemon-colored, 
or dark red urine, depositing a thick sediment. 

Petroleum. Involuntary micturition ; frequent desire 
to void urine, which passes off in a ^double stream, at- 
tended with burning pain, and tearing in the glans, and 
burning in the neck of the bladder ; the urine is either 
dark yellow, with a red sediment, or turbid, and red as 
blood, dark brown flocks subsiding after a time ; the 
urine is generally fetid, or exhales an ammoniacal smell ; 
throbbings in the urethra, with mucous discharge ; fre- 
quent nocturnal pollutions. Reddish eruptions on the 
glans, with itching and tearing ; cramp-like pains in the 
left spermatic cord, the scrotum being drawn up ; herpes 
on the genital organs. Brown spots on the wrist. Un- 
healthy skin ; even small wounds ulcerate and spread ; 
stitching in ulcerations. 

Petroselinum. Secretion of milky moisture in the ure- 
thra, and afterwards agglutination of the orifice by yel- 
low albuminous discharge, with slight burning when 



INDICATIONS OF THE MEDICINES. 239 

urinating, and tingling rather than burning from the 
perinseuni through the whole urethra, followed by pres- 
sure in the region of Cowper's glands. Profuse emis- 
sion of semen towards morning. 

Phosphorus. Profuse urination, smelling like garlic 
or sulphur, or having a strong ammoniacal odor, depos- 
iting a yellowish-white sediment; or acrid red or brown 
urine, with sediment of red sand or yellow mucus. 
Greasy pellicle on the urine ; cutting and smarting pain 
on urinating, with discharge of a few drops of mucus or 
blood ; difficult emission of urine, the passage feeling 
choked or impeded. Violent drawing in the testicles, 
and drawing stretching pains in the spermatic cord ; 
frequent erections and loss of semen for several clays 
together. Twitching, tearing, darting, and tension in 
the cheek-bones and jaw, with threatening caries. Sense 
of languor, indolence, and nervous debility, like that 
produced by excessive loss of animal fluids ; great aeute- 
ness of the senses, and tendency to start easily ; giddi- 
ness and confusion of ideas, particularly in the morning ; 
unrefreshing sleep, disturbed by anxious dreams. Dart- 
ing pains in the left side of the chest; aching in the pit 
of the stomach, with flatulency ; discharge of blood from 
slight wounds or ulcers ; lymphatic swellings, perforated 
in many places by fistulous openings ; scurfy eruptions 
and pimples on the skin, with falling off of the hair ; 
brown or bluish-red blotches on the skin ; sickly, wan, 
and pallid countenance. 

Platina. Red urine, with white clouds, becoming tur- 
bid, and depositing a red sediment on the sides of the 
vessel ; congestion of blood to the uterus ; painful sensi- 
tiveness, and continual pressure in the region of the 



240 CHARACTERISTIC EFFECTS AND 

female sexual organs, with internal, almost constant 
chills ; frequent urging to urinate, as if the bladder were 
contracted spasmodically. 

Plumbum. Tenesmus of the neck of the bladder, be- 
fore, during, and after urination, the urine looking satu- 
rated, brown, and mixed with blood ; copious red or yel- 
low urine, without containing albumen. Pulling, tearing, 
and contractive pain in the testicles, spermatic cord, and 
penis, attended with violent pain in the hypogastrium ; 
it is generally that both testicles are attacked, though 
sometimes one is more painful than the other ; when the 
pains are violent, the testicles are drawn up ; and the 
scrotum becomes wrinkled during the paroxysm, relaxing 
again during the remission. Serous infiltration and 
puffy appearance of the skin, which is dry, scaly, rough, 
yellowish, or clay-colored, with dark spots; violent tear- 
ing, crushing, sudden, violent jerkings in the bones, oc- 
curing at night, and depriving the patient of rest. 

Pulsatilla. Retention of urine, with redness and heat 
of the external region, and painful when pressed ; con- 
tinual pressure on the neck of the bladder, with cutting 
pain, as if occasioned by flatulence. The urine is gener- 
ally dark brown, depositing sandy or brick-dust sediment, 
or occasionally of a violet color ; creeping, pressure, and 
drawing in the urethra, w T hich is often contracted, the 
stream becoming very thin ; discharge of whitish fluid, 
or dark blood from the urethra. Stinging itching in the 
prepuce when sitting and lying, but not when walking ; 
biting itching under the prepuce, near the glans ; swell- 
ing of the right side of the scrotum, which hangs down 
low ; the right testicle is drawn up and swollen, in con- 
junction with the spermatic cord, with tensive pains, the 



INDICATION'S OF THE MEDICINES. 241 

left testicle being greatly relaxed. Inflammatory action 
in the prostate gland, with pain and swelling in the 
region of the neck of the bladder, with intermittent 
stream and spasmodic contractive pain after urination, 
extending to the thighs ; swelling of the veins of the 
testicles ; burning, stinging in the vagina and labia ; 
violent tearing, boring, and cutting pains in the eye, 
with pressure as from heat, and feeling as if sand were 
in the eyes ; inflammation of the eyes, with profuse 
lachrymation, secretion of mucus and dimness of sight ; 
redness and swelling of the lids ; contraction of the 
pupil, followed by dilatation ; burning itching of the 
skin, with bluish-red swellings ; ulceration of the skin, 
similar to that present in caries, with stinging, biting 
pain, or burning as from hot coals, with itching all 
round ; swelling of the veins round the ulcer, with hard 
and shining swelling of the part. Weakness, weariness, 
and heaviness, with coldness and blueness of the skin, 
and great chilliness, increased when the pains in the 
limbs are present ; bruised pain in the muscles of the 
thighs, with unsteadiness and weakness of the knees, 
which give way when walking. Xumb pain in the soles 
of the feet, or tingling and stinging when standing, as if 
they were pithy and gone to sleep ; gastric symptoms, 
consisting of nausea, hiccough, frequent eructations, with 
putrid risings, pain, and pressure, with fulness of the 
stomach ; whi-ning and melancholy temper. 

Rhododendron chrysanthum. Itching and increase of 
sweat about the scrotum, which shrinks easily; the tes- 
ticles are drawn up, swollen, and painful to the touch ; 
the pains are contusive and drawing, affecting first one 
and then the other ; violent stitching in the testicle, as 
21 



242 CHARACTERISTIC EFFECTS AND 

if contused, felt only when sitting ; sometimes the pain 
is pricking, commencing in the right testicle, and spread- 
ing in a zigzag along the perinaeum to the anus, lasting 
some minutes, and arresting the breathing while it 
lasted ; darting, tearing pains in the bones. 

Rhus toxicodendron. Incontinence of urine, particu- 
larly during rest ; the emission is often profuse, fre- 
quently every few minutes ; double stream of urine, with 
snow-white sediment, and burning in the urethra, which 
is nearly closed by swelling. Swelling of the prepuce, 
close to where it unites with the glans ; thickening and 
hardness of the scrotum, or puffy, itching swelling, at- 
tended with a humid eruption ; vesicles on the glans, 
which is swollen, and accompanied with biting in the 
urethra ; warts on various parts of the body ; vesicles 
and tubercles on the joints; pressure, with drawing in 
the periosteum, as if the bone were' scraped ; numbness 
of various parts, or paralysis of the lower limbs, with 
dragging, slow, difficult walk, and tingling in the parts ; 
staggering, and inability to stand erect. 

Ruta graveolens. Pressure in the region of the neck 
of the bladder, as if the neck were painfully contracted, 
after micturition ; the quantity of urine discharged is 
inconsiderable, but the sensation immediately occurs as 
if the bladder were again full ; excessive urging, although 
but few drops pass, and there is painful burning at the 
same time ; burning, gnawing pain in the periosteum ; 
bruised feeling in the thighs ; on rising the patient is 
unable to stand, so that he falls back on the chair ; the 
bone feels broken, the thighs giving way from weakness 
and pain ; cramp-like tearing, with pressure in the 
limbs ; affections of the periosteum, such as resuft from 
ivjuries. 



INDICATIONS OF THE MEDICINES. 243 

Sabina. Intermittent, almost constant desire to uri- 
nate, with fleeting, burning pains in the region of the 
bladder. Smarting during urination, the urine being 
turbid at the time ; inflammatory action in the urethra, 
with purulent discharge ; discharge of slime from the 
vagina, and sanguineous urine, with strangury ; severe 
stitches in the vagina from before backwards ; swelling 
of the periosteum, with aching, burning pain. 

Sarsaparilla. Burning and scraping in the urethra 
during micturition, with emission of oblong flocks ; 
severe tenesmus, as in gravel, with emission of white, 
acrid, turbid matter, and mucus ; symptoms similar to 
hydrargyrosis ; discharge of yellow pus from the urethra, 
with redness and inflammation of the glans ; herpes on 
the prepuce. Intolerable stench about the sexual organs. 

Scilla maritima. Great desire to urinate, with emis- 
sion of clear urine ; incontinence sometimes at first re- 
sults. Afterwards scanty emission of dark urine, of a 
brownish yellow, foaming, and forming flocks ; red sedi- 
ment in the urine ; compressive pain in the testicles ; 
stitches in the glans of a dull nature. 

Sepia. Urine dark and turbid, as if mixed with 
mucus ; urine throwing down a brick-dust or red sedi- 
ment, or occasionally mixed with blood ; pressure on the 
bladder, with burning after micturition ; frequent incon- 
tinence of urine, more urine being passed than drink has 
been taken. Smarting and tearing in the urethra ; 
copious perspiration of the sexual organs, the glans hot 
and itching, the prepuce being sore ; continual suppura- 
tion and itching of the prepuce ; heat, cutting, pinching, 
and tearing in the testicles ; gonorrhoea, preceded by 
complete inertia of the genital organs for some days ; 



244 CHARACTERISTIC EFFECTS AND 

coldness of the parts ; general nervous excitement, which 
is almost always accompanied by sleeplessness, and occa- 
sionally loss of appetite ; formication, voluptuous titilla- 
tion, and occasionally acute stitches in the urethra or 
vagina ; frequent urging to urinate ; discharge of mucus, 
which gradually becomes milky, and at last slightly 
greenish ; it increases from the first to about the tenth 
clay, and decreases about the fifteenth, although liable to 
last for months. Tremulous motion of the whole body, 
with uneasiness, and pulsations in various parts; weak- 
ness and faintness, sensibility to cold ; profuse perspira- 
tion when taking exercise ; great weariness on rising ; 
pulse small, feeble, and irritable ; tendency to congestion. 

Silicea. Ulcerations discharging fetid, sanguineous, 
whitish, or yellowish pus, generally thick and tenacious ; 
ulcerations with shaggy, callous edges, penetrating to 
the bone ; the soft parts round about-are swollen, hard, 
and blue ; the orifices of fistulous canals are callous ; 
hectic fever produced by caries, with exfoliation of the dis- 
eased portion of the bone, attended with profuse secretion 
of partly malignant or partly healthy pus, and extreme 
nocturnal perspiration ; yellow, light-colored, hot urine, 
depositing a yellow gravel, attended with smarting itch- 
ing, with red spots on the glans ; swelling of the prepuce ; 
with itching, humid pimples on the outside ; effusion of 
fluid into the tunica vaginalis of the scrotum, which 
itches, and is covered with moisture ; pain in the left 
testicle, as if swollen or indurated. 

Spongia tosta. Frothy, clear, saffron-colored urine, 
depositing a yellow sediment ; or urine with thick gray- 
ish-white deposit ; voluptuous itching of the tip of the 
glans, with itching burning of the scrotum; squeezing, 



INDICATIONS OF THE MEDICINES. 245 

strangulating pain in the testicles ; dull stitches extend- 
ing to the spermatic cord, which is painful and swollen j 
increasing swelling of the testicle, which is firm, smooth, 
and round, the size of the fist, without alteration of the 
external skin; generally painless, except dull, stitching 
pains occasionally ; the testicles are sensitive to pressure, 
. withdrawing in the spermatic cord and loins ; hard swell- 
ing and suppuration of various glands. 

Staphysagria. Sticking pain in the right side of the 
glans when standing or walking ] passing of the urine at 
night is attended with erection of the penis, with burning 
in the region of the neck of the bladder ; the urine itself 
being emitted in drops. Violent drawing burning stitches 
from the right abdominal, ring, apparently in the sper- 
matic cord, as far as the right testicle, which is painless to 
the touch ; drawing and tearing in the right testicle, 
with pressure, as if it were compressed ; white humid 
excrescences in the hollow behind the corona glandis, 
with similar excrescences on the corona itself, both itch- 
ing when rubbed ; pressive pain in the periosteum of the 
bones, not altered either by motion or rest, nor increased 
by pressure ; blackness, brittleness, and caries of the 
teeth ; despondency and uneasiness as to the state of the 
health ; extreme irritability of temper, and susceptibility 
to vexatious impressions ; sudden impulses ; embarrass- 
ment and confusion of the intellectual faculties ; incapa- 
bility of sleeping, owing to nervous excitement ; dulness 
of hearing, and mistiness before the eyes ; tremulousness, 
with palpitation of the heart at the least excitement, or 
even exercise. 

Stramonium, Sensation of impossibility of retaining 
the urine, and as if the urethra were too narrow and 
21* 



246 CHARACTERISTIC EFFECTS AND 

wanted dilating ; frequent emission of urine, passing in 
drops, but retained at first for a minute, before making 
its appearance; during urination no stream is formed, in 
spite of powerful straining; the urine is warmer than 
usual, but passes only in drops ; copper-colored spots on 
the skin ; discoloration of old cicatrices. 

Sulphur. Retention or very scanty emission of urine, 
with discharge of drops of bloody urine, after great ef- 
forts ; frequent and sudden desire to urinate, preceded 
by cutting in the hypogastrium, with thin or intermittent 
stream of urine ; the urine deposits red or whitish sedi- 
ment or slime, and blood is mixed with it, and is often 
very acrid and fetid, or covered with a greasy pellicle ; 
smarting, burning, itching, or cutting in the urethra 
(which is frequently swollen at its orifice), during, before, 
or after urination ; bluish coldness of the whole penis ; 
violent itching of the glans ; redness and swelling of the 
prepuce, with secretion of fetid pus from its inner sur- 
face ; it becomes stiff and hard as leather ; it shines on its 
inner surface, and secretes a disgustingly smelling ichor. 
Thickening and swelling of the epididymis, with pressure 
and tension in the scrotum and spermatic cord ; burning 
and sore feeling in the vagina, with inflammation of one 
of the labia. Swelling of the glans, with purulent infiltra- 
tion or ulceration of the same, discharging thick yellow 
pus; these ulcerations have a bluish circumference, not 
very sensitive, the base being covered with pale red, 
spongy, insensible proud flesh, with a smooth and shining 
surface ; inflammatory swelling of the conjunctiva, which 
is interstitially distended ; redness and ulceration of the 
cornea ; puffy swelling of the eyelids ; purulent discharge 
from the eyes ; contraction and immobility of the pupil ; 



INDICATIONS OF THE MEDICINES. 247 

discharge of acrid tears, intolerance of light, with vio- 
lent tearing pains round the eves and in the temples, 
considerably aggravated at night ; fungous excrescences 
on the skin ; biting, itching, and stinging in the diseased 
parts. Sad, melancholy disposition, with irritability 
and inclination to tears ; confusion and distraction of 
the head, with dizziness, fulness, and pressure ; attacks 
of giddiness, ending in fainting ; great restlessness, ex- 
treme exhaustion being induced by the slightest exertion ; 
pulse small, quick, and irritable ; tremulous palpitation 
of the heart ; tendency of the limbs to become numb 
and torpid. 

Terebinthina. Inflammatory symptoms about the 
bladder; violent dragging and cutting pains, or fre- 
quently recurring spasmodic pains, with burning in the 
bladder and urethra, difficult micturition, or complete 
suppression of urine ; the urine is generally red and 
scanty, or even bloody, smelling of violets, depositing 
muddy white-yellow or slimy sediment ; dysuria, at- 
tended with real urethritis, with painful erections ; 
violent crampy pains in the left testicle, and along the 
left spermatic cord. 

Teucrium marum. Sore feeling, with pressure in the 
fore part of the urethra, attended with smarting pain 
when not urinating ; drawing pain at the root of the 
penis on the left side, extending to the integuments of 
the left testicle, so that they are painful for some time 
after, when touched. 

Thuja occidentals. Frequent and copious urination, 
accompanied by straining, the stream being interrupted 
several times before the urine is entirely voided, and 
accompanied with burning pains ; after micturition some 



248 CHARACTERISTIC EFFECTS AND 

urine remains in the urethra, which drops out afterwards ; 
the urine is pale at first, but becomes cloudy on standing ; 
red urine, depositing brick-dust sediment; burning and 
cutting in the urethra during urination ; lancinations in 
the fore part of the urethra, with burning, piercing 
stitches ; painful stitches in the fore part and in the ex- 
ternal surface of the prepuce, stinging and itching in the 
fore part of the glans ; itching and pricking in the scro- 
tum ; drawing sensation in the testes, with swelling of 
the inguinal glands ; profuse perspiration of the sexual 
organs, considerable swelling of the prepuce, which has 
red excrescences on its inner surface ; reddish pimples 
on the prepuce, changing to an ulcer, which is covered 
with scurf, itches, and is sometimes painful and burning ; 
fig-warts on the sexual organs, and around the anus, 
which itch, sting, and burn, and occasionally bleed ; 
smarting of the female sexual organs when urinating ; 
tubercles in the mucous membrane of the vagina ; chronic 
ulcers, with flat but widely indurated edges, grayish 
bottom, and discharging ichorous and fetid pus ; falling 
off of the hair ; sensitiveness to cold, and deficiency of 
animal heat ; great coldness along the spinal column ; 
sleeplessness, depression of spirits, vertigo, difficulty of 
thinking ; benumbing, gnawing, twitching, crampy pains 
at the nape of the neck, back, loins, and shoulders, &c. ; 
palpitation of the heart. 

Uva ursi. Painful micturition, with burning; slimy, 
purulent urine ; mixed with blood. 

Veratrum album. Burning, acrid, dark, red, greenish, 
or yellow, turbid urine ; pain in the urethra, as if con- 
stricted behind the glans, accompanied with ineffectual 
desire to urinate, the bladder being empty ; burning in 



INDICATIONS OF THE MEDICINES. 249 

the urethra when urinating ; soreness of the prepuce, 
and drawing pains in the testes ; violent erections. 
Violent ophthalmia, with cutting pains in the eyes, and 
profuse lachryniation ; dilatation or contraction of the 
pupils, with momentary vanishing of sight. 

Zincum. Involuntary discharge of urine ; turbid and 
loam-colored urine ; yellow urine, depositing flocks ; press- 
ure on the bladder ; intensely painful drawing in the urethra 
and fore part of the penis ; sharp cutting, tearing, itching, 
and burning in the urethra ; great falling off of the hair ; 
herpes of the tonsils, of the palate, or root of the tongue ; 
swelling of the tonsils, with slight redness, followed by 
irregular whitish-blue flat spots, having the appearance 
of lard, the epidermis being raised ; the whitish, smooth, 
jelly-like surface feels hard, and cannot be abraded; 
stinging, smarting, and sore feeling, which is aggravated 
by hawking or swallowing. 



INDEX. 



Acidum fluoricum, 199; 

nitricum, 126, 200 ; 

oxalic, 166; 

phosphoricum, 127, 201; 

sulphuric, 168. 
Aconitum napellus, 202. 
Agaricus muscarius, 202. 
Agnus castus, 202. 
Allium cepa, 139. 
Alopecia, 108; 

treatment of, ib. 
Alumin. met., 169. 
Antimonium crudum, 203. 
Antimonii tartras, 203. 
Apis mellifica, 160, 204. 
Argenti nitras, 204. 
Arnica montana, 161, 204. 
Arsenicum album, 162, 205. 
Asafoetida, 206. 
Aurum metallicum, 206. 

Baptisia, 167. 
Balanorrhoea, 52; 

treatment of, 53 ; 

preventive treatment of, 
53; 

table of indications for, 55. 
Barytae carbonas, 206. 



Belladonna, 161, 206. 
Bladder, inflammation of, 69 ; 
treatment of, ib. 
chronic inflammation 
stone in, 187 ; [of, 70 ; 

treatment of, 190. 
catarrh of, 1 93 ; 

treatment of, 194. 
hypertrophy of, 196 ; 
treatment of, 197. 
spasm of, 197 ; 

treatment of, 198. 
Blenorrhcea vesicae, 193; 

treatment of, 194 
Bone, caries of, 121 ; 

treatment of, 122. 
death of, 122; 

treatment of, ib. 
inflammation of, 116; 
treatment of, 117. 
Bony tumor, 119 ; 

treatment of, 120. 
Bryonia alba, 163, 207. 
Bubo, 96 ; 

primary, ib. ; 
secondary, ib. ; 
constitutional, ib. ; 
acute, ib. ; 

251 



252 



INDEX. 



Bubo, indolent, 98; 
phagedenic, ib. ; 
treatment of, 99. 
Cachexia, syphilitic, 124 ; 

treatment of, 125. 
Calcis carbonas, 207. 
Calculus, 187 ; 

treatment of, 190. 
Camphora, 207. 
Cannabis sativa, 208. 
Cantharis, 163, 209. 
Capsicum, 209. 
Carbo vegetabilis, 210. 
Caries, 121 ; 

treatment of, 122. 
Causticum, 210. 

Cerebro-spinal meningitis, 148- 
159; 
treatment of, 159-171. 
Chamomilla, 210. 
Chancre, 87, 89; 
elevated, 89; 
Hunterian, 89 ; 
gangrenous, 89 ; 
indurated, 89; 
phagedenic, 89, 91 ; 
sloughing, 88; 
superficial, 87; 
treatment of, 92, 93 ; 
diet for, 93 ; 

table of indications for, 96. 
Characteristic effects of medi- 
cines, 199-249. 
Chordee, 60 ; 

treatment of, 61 ; 
neglected, consequences 
of, 60. 



Cimicifuga, 167. 
Cinchona, 211. 
Cinnabaris, 211. 
Cirsocele, 175; 

treatment of, 176 ; 
surgical treatment of, 
178. 
Clematis erecta, 211. 
Cocculus, 212. 
Colchicum autumnale, 212. 
Colocynthis, 212. 
Conium maculatum, 170, 213. 
Constitutional syphilis, 102. 
Copaibae balsamum, 185, 213. 
Cowper's glands, inflammation 
of, 62 ; 
treatment of, ib. 
Crotalus hor., 167. 
Cubebae piper, 213. 
Cup. acet.^.169. 
Cystitis, acute, 69; 

treatment of, ib. 
chronic, 70; 

treatment of, ib. 

Digitalis purpurea, 213 ; 
Doses, 17; 

repetition of, 20 ; 

alternation of, 21. 
Dulcamara, 213. 
Dysuria, 178; 

treatment of, 179. 

Elaps cor. 164. 
Enuresis, 181 ; 

treatment of, ib. 
Ephelides, 105. 



INDEX. 



253 



Ephelides, treatment of, 105. 
Epididymis, inflammation of, 
70; 
treatment of, 71 ; 
table of indications for, 
73. 
Erections, 59; 

preventive treatment 

of, 59; 
treatment of, ib. 
Erigeron, 187. 
Erythema, 102; 

treatment of, ib. 
Eupat. perf., 168. 
Exostosis, 119 ; 

treatment of, 20. 
on the inner part of 
the cranium, conse- 
quences of, ib. 

Ferri sulphas, 214. 
Fig-warts, 133 ; 

treatment of, 134. 

Gelseminum, 139, 165. 
Glans, itching of, 66; 

treatment of, 66. 
Gleet, 47, 49; 

treatment of, 48; 
diet for, ib. 
Gonorrhoea, 23 ; 

treatment of, 24, 26; 
preventive treatment 

of, 25; 
table of indications for, 

35; 
diet for, 25. 
22 



Gonorrhoea of the female, 38, 
44; 
treatment of, 40 ; 
table of indications 
for, 46. 
Gonorrhoeal accessory affec- 
tions, 59. 
ophthalmia, 80 : 

consequences of, 81; 
treatment of, 81, 82. 
Graphite, 214. 
Gravel, 187 ; 

treatment of, 190. 
Guaco, 214. 
Gummata, 112; 

treatment of, ib. 

Hematuria, 182; 

treatment of, 183. 
Hair, falling off of, 108 ; 

treatment of, ib. 
Hamamelis, 187. 
Helleborus niger, 214. 
Hepar, sulphuris, 214. 
Herpes of the prepuce, 67 ; 

treatment of, ib. 
Hydrocele, 173 ; 

treatment of, 174. 
Hyoscyamus niger, 170, 215. 

Ignatia amara, 215. 

Induration of testicle, 75. 

Introduction. Syphilis: prima- 
ry ; constitutional ; second- 
ary; tertiary. Hygiene. Se- 
lection of medicines; doses, 
13-22. 



254 



INDEX. 



Iodium, 215. 

Iris, syphilitic inflammation of, 
109; 
treatment of, 109. 
Iritis, syphilitic, 109; 

treatment of, 111 ; 
neglected, consequences 
of, ib 
Ischuria, 178 ; 

treatment of, 179. 

Jacaranda caroba, 216. 

Kali carbonas, 216. 
Kali iodidum, 217. 
Kreasotum, 166. 

Lachesis, 165. 
Lycopodium, 170. 

Maculae, 105; 

treatment of, 106. 
Masturbation, 140; 

consequences of, ib. ; 
treatment of, 142. 
Medicines, rules for selection 
of, 16. 
selection of, 16. 
characteristic effects 
of, 199-249. 
Mercurius, 218, 235. 
Mezereum, 235. 
Millefolium, 236. 
Moschus, 236. 

Mucous membrane, syphilitic 
diseases of, 104. 



Natri murias, 236. 
Necrosis, 121 ; 

treatment of, 122. 
Non-syphilitic diseases, 135. 
Nux vomica, 169, 236. 

Occimum canum, 187, 237. 
Onanism, 140; 

consequences of, ib. ; 
treatment of, 142. 
Ophthalmia gonorrhoeica, 80 ; 

treatment of, 82. 
Opium turcum, 170, 238. 
Orchitis, syphilitic, 113 ; 

treatment of, 115. 
gonorrhoeal, 74. 
Osteo-copus nocturnus, 121. 
Ostitis, 116; 

treatment of, 118. 

Paraphimosis, 68. 

Pathological observations, in- 
troductory, 13. 

Periosteum, inflammation of, 
116. 

Periostitis, ib. ; 

treatment of, ib. 

Petroleum, 238. 

Petroselinum, 238. 

Phimosis, 67 ; 

treatment of, 68. 

Phosphorus, 170, 239. 

Physalis alk., 182. 

Platinum, 239. 

Plumbum metallicum, 240. 

Prepuce, herpes of, 67 ; 

treatment of, ib. 



INDEX. 



255 



Priapism, 60 ; 

treatment of, ib. 
Prostatitis, 63; 

treatment of, ib. 
chronic, 64; 

treatment of, 65, 66. 
Pruritus glandis, 66. 
Pulsatilla nigricans, 240. 
Pupil, closure of, 109 ; 

use of palliatives for, ib. 

Rhododendron, 241. 

Rhus toxicodendron, 169, 242. 

Rupia, syphilitic, 106 ; 

treatment of, 107. 
Ruta graveolens, 242. 

Sabina, 243. 
Sarsaparilla, 243. 
Satyriasis, 60 ; 

treatment of, ib. 
Sarcocele, syphilitic, 113 ; 

treatment of, 115. 
Scaly eruptions, 105 ; 

treatment of, 107. 
Scilla maritima, 243. 
Scrotum, dropsy of, 173 ; 

treatment of, ib. 
Self-abuse, 140; 

consequences of, ib. ; 
treatment of, 142. 
Sepiae succus, 243. 
Silicea, 244. 
Spermatorrhoea, 135 ; 

neglected, consequen- 
ces of, 136 ; 
treatment of, 138. 



Spinal irritation, 146 ; 

treatment of, ib. 
Spongia marina, 244. 
Spots, syphilitic, 105 ; 

treatment of, 106. 
Squamae, 106; 

treatment of, 107. 
Staphysagria, 245. 
Stramonium, 245. 
Stranguria, 178; 

treatment of, 179. 
Stricture of the urethra, 75 ; 
treatment of, 77 ; 
mechanical treat- 
ment of, 78. 
Sulphur, 246. 
Sycosis, 133 ; 

Sycosis, treatment of, 134. 
Syphilis. 87, 102. 

infantile, 135; 
treatment of, 

Tabes dorsalis, 171 ; 

treatment of, 172. 
Terebinthina, 185, 247. 
Tertiary syphilis, 112. 
Testicle, swelled, 74, 113. 
Teucrium marum, 247. 
Thuja, 247. 
Treatment, general directions 

for, 13-22. 
True syphilis, 87. 
Tubercles, cutaneous, 103; 

deep-seated, 104; 

mucous, ib. ; 

syphilitic, ib. ; 

treatment of, 105. 



256 



INDEX. 



Uret hra, inflammation of, 38. 

haemorrhage from, 61. 
haemorrhage, treatment 

of, 75, 77. 
stricture of, ib. ; 
mechanical treatment 
of, 78. 
Urinary deposits, composition 

of, 188. 
Urine, incontinence of, 181 ; 
treatment of, ib. 
bloody, 182 ; 

treatment of, 183. 
retention of, 178 ; 



Urine, retention of, treatment of, 
Urtica urens, 187. [179. 

Uterus, inflammation of, 40. 
Uva ursi, 248. 

Vaginitis, 39. 
Varicocele, 175 ; 

treatment of, 176. 
Venereal rheumatism, 83 ; 

treatment of, 84-86. 
Veratrum album, 248. 
Viride, 169. 

Zincum metallicum, 249. 



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